title: Neuroimaging analysis of a case with left homonymous hemianopia and left hemispatial neglect.
abstract: OBJECTIVE
  To correlate the neuro-ophthalmological observations with the magnetic resonance images (MRI) and positron emission tomographic (PET) findings in a case with left homonymous hemianopia and left hemispatial neglect.
  
  
  METHODS
  A 57-year-old woman underwent surgery for a ruptured anterior communicating artery aneurysm. After she recovered consciousness, it was found that she had left homonymous hemianopia and left hemispatial neglect. Although the hemispatial neglect slowly improved, the homonymous hemianopia persisted. MRI and measurements of cerebral glucose metabolism by 2-fluoro-2-deoxy-D-glucose(FDG)-PET were performed 1 year later.
  
  
  RESULTS
  MRI revealed infarctions on the medial surface of the frontal lobe, on the right medial surface of the occipital lobe, and global atrophy of the right cortical hemisphere. FDG-PET disclosed severe glucose hypometabolism in the entire right hemisphere. Glucose metabolism in the right occipital cortex was 61.1% of that in the homologous region on the left side, 62.8% in the right anterior cingulate gyrus, and 93.8% in the temporal-parietal-occipital junction.
  
  
  CONCLUSIONS
  The low glucose metabolism in the right visual cortex explains the persistent left hemianopia, and that in the right anterior cingulate gyrus and the right temporal-parietal-occipital junction may be responsible for the left hemispatial neglect. The relatively mild damage in the right temporal-parietal-occipital junction explained the recovery of the neglect symptom. Measurements of regional cerebral glucose metabolism by PET are useful for determining the cause of cerebral visual dysfunction and its prognosis after a cerebral lesion.
authors.affiliation: Department of Ophthalmology and Visual Science, Tokyo Medical and Dental University, Graduate School, Tokyo, Japan.
authors.forename: Shoichi
authors.initials: S
authors.lastname: Mizoguchi
authors.forename: Yukihisa
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Motohiro
authors.initials: M
authors.lastname: Kiyosawa
authors.forename: Manabu
authors.initials: M
authors.lastname: Mochizuki
authors.forename: Kenji
authors.initials: K
authors.lastname: Ishii
mesh_terms: D017542:Aneurysm, Ruptured / Q000150:complications; D001921:Brain / Q000000981:diagnostic imaging* / Q000378:metabolism / Q000473:pathology; D005260:Female; D019788:Fluorodeoxyglucose F18; D005947:Glucose / Q000378:metabolism; D006423:Hemianopsia / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D006801:Humans; D002532:Intracranial Aneurysm / Q000150:complications; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010468:Perceptual Disorders / Q000175:diagnosis* / Q000209:etiology / Q000378:metabolism; D013345:Subarachnoid Hemorrhage / Q000209:etiology; D014055:Tomography, Emission-Computed; D058609:Visual Field Tests; D014794:Visual Fields
chemical_list: D019788:Fluorodeoxyglucose F18; D005947:Glucose