Recovery of Visual Field Defect via Corpus Callosum in a Patient with Cerebral Infarct

Abstract

Recovery mechanism of visual field defect in stroke patients has not been clearly elucidated. In this study, we report on a patient with a cerebral infarct who showed recovery of visual field defect via the corpus callosum, using diffusion tensor tractography (DTT) for optic radiation (OR). A 57-year-old male patient underwent conservative management for a cerebral infarct in the subcortical white matter of the right temporal lobe. Left homonymous hemianopsia was detected on the 2-week Humphrey visual field test. However, the patient showed improvement of hemianopsia with time; consequently, a left lower peripheral visual defect with the resolution of the upper and medial portions of the initial left hemianopia was observed on the 11-month Humphrey visual field test. Both 2-week and 11-month DTTs for the right OR showed a discontinuation between the right lateral geniculate nucleus (LGN) and the right OR. On 2-week DTT, the left OR was connected to the transcallosal fibres, and on 11-month DTT, these transcallosal fibres were elongated to the right primary visual cortex via the right posterior OR. The visual field defect in this patient appears to have recovered by the neural pathway originating from the left OR and terminating in the primary visual cortex via the transcallosal fibres and right distal OR. We believe that the results of this study may suggest one of the mechanisms for recovery of visual field defect following injury of OR in stroke patients.

• Brain plasticity
• diffusion tensor tractography
• hemianopia
• optic radiation
• visual field defect

Acknowledgements

This research was supported by Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science and Technology (2012R1A1A4A01001873).

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.

Note: Figure 1 of this article is available in colour online at http://informahealthcare.com/oph.