From the Guidelines
An occipital stroke is characterized by sudden visual disturbances, particularly homonymous hemianopia, and requires immediate medical attention to prevent permanent vision loss. The most prominent symptoms of an occipital stroke include visual disturbances, such as complete or partial vision loss, visual hallucinations, or visual distortions, where objects appear larger, smaller, or distorted 1. Patients may also experience difficulty recognizing objects, faces, or colors (visual agnosia), problems with reading despite normal vision (alexia), or difficulty judging distances and movement. Unlike strokes in other brain regions, occipital strokes typically don't cause weakness, numbness, or speech problems unless other brain areas are also affected. Headaches may accompany these visual symptoms, particularly in the back of the head.
Some key points to consider when diagnosing an occipital stroke include:
- The importance of prompt recognition of stroke symptoms, as delays in seeking medical attention can decrease the opportunity for time-sensitive treatments 1
- The use of public health campaigns, such as FAST, to increase awareness of stroke symptoms and improve recognition 1
- The need for immediate diagnostic studies, including brain imaging, to confirm the diagnosis and guide treatment decisions 1
- The importance of assessing the patient's vital signs and medical history to identify potential causes of the stroke and guide treatment 1
In terms of treatment, it is essential to note that prompt medical attention is critical to prevent permanent vision loss. The visual deficits occur because the occipital lobe contains the primary visual cortex, which processes visual information from the retina. The most critical factor in improving outcomes is the timely initiation of treatment, which can significantly reduce the risk of permanent vision loss. Therefore, it is crucial to seek medical attention immediately if symptoms of an occipital stroke are suspected.
From the Research
Symptoms of Occipital Stroke
- Homonymous visual field defects are a common symptom of occipital stroke, which can occur unilaterally or bilaterally 2
- Visual field loss can impair or preclude reading and driving, and has a significant impact on quality of life 2, 3
- Patients with occipital stroke may present with isolated visual symptoms, rather than direct neurological symptoms 4, 2
- Visual symptoms of stroke can include transient binocular visual loss or infarction of the visual cortex 2
Visual Field Defects
- Visual field defects (VFDs) are found in approximately 79% of patients with occipital infarction 3
- Evaluation of VFD after 6 months revealed improvement in approximately 52% of patients 3
- Severity of VFD is related to vision-related quality of life, and VFD improvement results in better quality of life 3
Diagnosis and Management
- Diagnosis of stroke and transient ischemic attacks is crucial, as they are important harbingers of further cerebrovascular events 2
- Ophthalmologists are well placed to ensure that patients with visual symptoms of stroke receive appropriate acute treatment and secondary prevention 2
- Recognition of strokes presenting with mainly visual field defects is challenging for both patients and healthcare professionals 4