Pediatric Homonymous Hemianopia

Imaging of Retrochiasmal and Higher Cortical Visual Disorders

“…2 Other etiologies include hemorrhage, neoplasm, infection, trauma, progressive multifocal leukoencephalopathy, and posterior reversible encephalopathy syndrome. 18,29 For pediatric patients, trauma and neoplasm are the most common lesions. 29 Other less common causes include adrenoleukodystrophy, acute disseminated encephalomyelopathy, and periventricular leukomalacia, which have other associated clinical features.…”

“…18,29 For pediatric patients, trauma and neoplasm are the most common lesions. 29 Other less common causes include adrenoleukodystrophy, acute disseminated encephalomyelopathy, and periventricular leukomalacia, which have other associated clinical features. 2 Lesions involving the striate cortex superior or inferior to the calcarine sulcus may result in inferior or superior quadrantanopia, respectively (Fig.…”

“…11). 2,29 Higher Cortical Visual Disorders Cerebral hemiachromatopsia Damages of the ventromedial aspect of the occipitotemporal cortex (posterior fusiform and lingual gyri: area V4 complex) may result in deficits of color perception of the contralateral hemifield or hemiachromatosia. 30 Many patients also have other visual perception symptoms (eg, homonymous superior quadrantanopia, pure alexia, prosopagnosia, and object agonosia, which is discussed in more detail later).…”

The Apparently Blind Infant

“…96 Trauma and tumors are the most common case of homonymous hemianopia in children. 314 Most cases of congenital homonymous hemianopia are due to unilateral or asymmetric cerebral lesions, but congenital optic tract syndromes do rarely occur. 381 Common structural causes are congenital lesions, such as porencephaly, arteriovenous malformations, and gangliogliomas.…”

Developmental abnormalities of the optic nerve and chiasm

“…Tract abnormalities may cause 14% of homonymous hemianopias in childhood, 77 but the majority of these are probably acquired. The tracts may be absent in association with optic nerve aplasia 78 Absence of the optic tracts on MRI studies may be associated with ipsilateral band atrophy and contralateral pallor, and with other visual system and cerebral abnormalities.…”