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  #1  
Old 04-01-2011
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Eye which visual field defect is this?

An aneurysm that has been detected at the junction of the anterior cerebral artery and the anterior communicating artery on the right has caused a visual field defect.What might visual field testing reveal?
A) Macular sparing
B) A left homonymous hemianopsia with macular sparing
C) A right nasal hemianopsia
D) A bitemporal inferior quadrantanopsia
E) A left homonymous inferior quadrantanopsia


SOURCE: Kaplan LN
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Old 04-01-2011
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The answer is : C.

The junction of right anterior cerebral artery and anterior communicating artery is located next to right optic nerve that carries impuls from lateral side of right retina (receiving images from nasal field).
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Old 04-01-2011
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C is the answer i guess.
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Old 04-01-2011
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I was thinking to post my notes on visual field defect due to cerebral artery lesions. But I was kind of busy doing my house works and I totally forgot. This is a time to type up my notes here. Thanks to struggle to bring this HY stuff here. You should know this for your step. This is ******* stuff.

Artery Defect - Ophthalmologic deficit

Anterior communicating artery - Bitemporal hemianopia

Internal carotid artery - Binasal hemianopia

Ophthalmic artery - Monocular blindness

Posterior cerebral artery - Homonymous hemianopia with macular sparing

Posterior communicating artery - Cranial nerve III palsy

That's all you need to know for step 1... Don't stress too much....

Source from UW
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Old 04-01-2011
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Thanks dude for the effort writing this....this is high yield...
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Old 04-01-2011
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great..thanks alott aktorque,.
In kaplan,answer is bitemporal inferior quadrantnopsia..i dont know how..but i guess there is some mistake in the book.
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Old 04-01-2011
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Quote:
Originally Posted by struggle View Post
great..thanks alott aktorque,.
In kaplan,answer is bitemporal inferior quadrantnopsia..i dont know how..but i guess there is some mistake in the book.
I know... that qn is misleading and confusing. But know the one I gave you... it will help you on your exam.
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Old 09-04-2011
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Quote:
Originally Posted by struggle View Post
great..thanks alott aktorque,.
In kaplan,answer is bitemporal inferior quadrantnopsia..i dont know how..but i guess there is some mistake in the book.
I dont think so the answer in Kaplan is correct
Its D
The aneurysm will affect the superior aspect of optic chiasma leading to compression of upper nasal quadrant fibre of retina which in turn will lead to loss of Bitemporal inferior quadrantopsia initially which will ultimately lead to Bitemporal heteronymous hemianopsia if aneurysm enlarges and compresses whole of the optic chiasma.

Last edited by usmle2011; 09-04-2011 at 02:17 AM.
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Old 09-04-2011
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D
(HY neuroanatomy)
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Old 09-04-2011
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hmmm.. this is very high yield question
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Old 11-27-2011
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It's D 100%.

The early manifestation is Bilateral Lower Quadrantopia, but the aneurysm can expand and affect the optic chiasm leading to the same thing seen in pituitary expansion which is bitemp hemianop

b = PCA
c= internal carotid
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