Isolated homonymous hemianopia: A case series

The purpose of this study was to describe five case series of patients who presented with isolated homonymous hemianopia (HH) heralding the ministroke. This was a retrospective observational case series. This was a retrospective case series of five patients who presented to the outpatient department with isolated HH and was followed up for 6 months. 30-2 Humphrey's perimetric analysis and neuroimaging was done. Patients also underwent 2D ECHO and 24 h holter monitoring. These patients who presented with isolated HH had best corrected visual acuity of 6/6, N6 with Snellen's chart. Pupils and color vision were normal. On neuroimaging, one patient had infarction only in the occipital lobe. Two had infarction in the cerebellar hemispheres along with the occipital lobe and one patient had infarction in the deep white matter of temporal lobe, corona radiata, and the last patient also had chronic infarct in the frontal lobe. But all these patients presented with isolated HH. 2D ECHO and 24 h holter monitoring were within normal limits and had no neurological deficits. They were put on oral antiplatelets, statins and nutritional supplements, followed up by neurologists for 6 months and showed no neurological deficits on follow up. On finger confrontation test, hemianopia was still persistent. Isolated visual symptoms may be an early presenting characteristic of stroke. As there is a finite window of time during which therapy for stroke is effective, prompt identification of such atypical symptoms is crucial.