B7.032 Large Group: Visual System

Question 1

how to determine if a lesion impacting > 50% of visual field is in the occipital lobe or the chiasm

Answer 1

pupillary response affected by a lesion near the chiasm but not from the occipital lobe

Question 2

bitemporal hemianopia + superior nasal quadrants

Answer 2

most likely a chiasm lesion

no occipital lobe organization based on the patterns of field loss

Question 3

diffuse toxic process that can affect chiasm

Answer 3

methanol

Question 4

why order a non contrast CT in suspected brain bleed

Answer 4

contrast appears on imaging like blood, may cover up a bleed

Question 5

potential etiology of chiasm lesion causing bitemporal hemianopia + superior nasal quadrants

Answer 5

pituitary apoplexy, usually in presence of pituitary tumor

can compress nerves surrounding the glands

Question 6

etiologies of optic neuropathy

Answer 6

optic neuritis
multiple sclerosis
neuromyelitis optica

Question 7

multiple sclerosis

Answer 7

multifocal demyelinating lesion
dissemination in space and time
aggressive immunomodulating therapy

Question 8

etiology of an acute lesion of the optic tract

Answer 8

infarct that would also involve the brain

Question 9

etiology of a right optic “tractopathy”

Answer 9

right anterior choroidal artery occlusion

Question 10

cortical blindness

Answer 10

lesion in the cortical region resulting in blindness

Question 11

Anton’s syndrome

Answer 11

visual cortex and visual association cortex lesions
posterior reversible encephalopathy syndrome
person is blind but is not aware of the blindness