Clinical Reasoning: An 80-Year-Old Woman With a Homonymous Hemianopsia

Abstract

An 80-year-old woman who was experiencing visual symptoms for two years was found to have a left homonymous hemianopsia. On further evaluation the following month, she was noted to have simultanagnosia and alexia. Magnetic resonance imaging (MRI) of the brain did not reveal a structural etiology for the symptoms. [18 30 F]-fluorodeoxyglucose positron emission tomography-computed tomography (PET-CT) was performed to aid in the diagnostic investigation. This case highlights the differential diagnosis of a homonymous hemianopsia in the absence of a structural lesion on MRI and the role of PET-CT imaging in such patients.