From the Guidelines
A stroke affecting the occipital lobe or the posterior cerebral artery can cause vision loss in the upper visual fields, and prompt medical attention is crucial to minimize permanent damage. This specific pattern of vision loss, called inferior altitudinal hemianopia, occurs because the lower portion of the occipital cortex (which processes visual information from the upper visual fields) becomes damaged due to inadequate blood supply 1. The posterior cerebral artery supplies blood to the occipital lobe, and when this artery becomes blocked or ruptures, the brain tissue responsible for processing upper visual field information can die. Patients with this condition typically describe it as not being able to see the upper half of their visual world, almost as if there's a horizontal line across their vision with everything above it being dark or missing.
Some key points to consider in the management of such conditions include:
- The importance of early diagnosis and treatment, as emphasized in the management of central retinal artery occlusion 2
- The need for urgent brain magnetic resonance imaging with diffusion-weighted imaging, vascular imaging, and clinical assessment to identify patients at highest risk for recurrent stroke 3
- The classification of acute retinal arterial ischemia as a stroke equivalent, representing an ophthalmologic and medical emergency 3
- The age- and sex-adjusted incidence of central retinal artery occlusion, which rises to 10.1/100,000 person-years in those >80 years of age 2
The deficit is usually permanent, though some patients may experience partial improvement over time as the brain attempts to compensate. Prompt medical attention for any sudden vision changes is crucial, as early intervention for stroke can help minimize permanent damage. Patients with acute retinal arterial ischemia should be managed accordingly, with a focus on reducing the risk of subsequent stroke and cardiovascular events 3.
From the Research
Vision Loss in Upper Fields Due to Stroke
- The specific type of stroke that causes vision loss in the upper fields is not explicitly stated in the provided study 4.
- However, the study mentions that embolic disease of the anterior or posterior vascular territories may lead to disturbance of vision, including visual field loss 4.
- It also notes that visual symptoms of stroke can present as isolated visual symptoms, and that ophthalmologists play a crucial role in diagnosing and managing these patients 4.
- The study discusses the management of ischemic stroke in general, as well as the management of events involving the anterior and posterior circulation, but does not provide specific information on the type of stroke that causes vision loss in the upper fields 4.