Patterns of Recovery from Homonymous Hemianopia Subsequent to Infarction in the Distribution of the Posterior Cerebral Artery

Abstract

The authors performed a prospective study of recovery from complete homonymous hemianopia in 69 patients who had suffered ischemic occipital lobe infarction. Findings documented with kinetic perimetry were evaluated with a planimetric technique. Improvement was found in 32 patients (47.8%), and the temporal course of improvement as well as the location of improvement in the visual fields in these patients were investigated.

Recovery of function was more common in the lower quadrants (46.9%) and in the temporal crescent (75%). Initial improvement was observed most often in the lower quadrants (37.5%) and was associated with preservation of the cuneus in CT studies. This structure was involved in brain infarction in 71.7% of patients in whom recovery of the upper quadrants was observed. The occipito-temporal gyri were affected much less frequently (28.6%) in the latter group of patients. The results suggest that vascular mechanisms were operant in the recovery process.

Key Words:

• occipital infarction
• posterior cerebral artery
• homonymous visual field defects
• mode of recovery