- Stroke (ischemic or hemorrhagic)
- Tumor causing damage to the posterior visual pathways (intra-axial primary or metastatic)
- Aneurysm
- Demyelinating disease
- Trauma
- Abscess
- Arachnoid cyst
What is the pathophysiology of quadrantanopia?
Quadrantanopia can be associated with a lesion of optic tract pathway. While quadrantanopia can be caused by lesions in the temporal and parietal lobes, it is most commonly associated with lesions in the occipital lobe 1).
What causes homonymous superior quadrantanopia?
Homonymous superior quadrantanopia is caused by damage to the contralateral inferior parts of the posterior visual pathway: the inferior optic radiation (temporal Meyer loop), or the inferior part of the occipital visual cortex below the calcarine fissure.
Where are superior quadrantanopias most commonly found?
The location (and frequency) of lesions causing superior quadrantanopias was occipital lobe (83%), parietal lobe (3%), and temporal lobe (13%). Other localizing signs were associated with 4%, 100%, and 0% of lesions located in the occipital, parietal, and temporal lobes, respectively.
Which lesions of the brain are associated with inferior quadrantanopia?
Results: Cerebrovascular disorders accounted for most lesions. The location (and frequency) of lesions causing inferior quadrantanopia was occipital lobe (76%), parietal lobe (22%), and temporal lobe (2%). Other localizing signs were associated with 6%, 89%, and 0% of lesions located in the occipital, parietal, and temporal lobes, respectively.
Why do we get quadrantanopia?
Homonymous superior quadrantanopia is caused by damage to the contralateral inferior parts of the posterior visual pathway: the inferior optic radiation (temporal Meyer loop), or the inferior part of the occipital visual cortex below the calcarine fissure.
What lesion causes quadrantanopia?
Quadrantanopia can be associated with a lesion of optic tract pathway. While quadrantanopia can be caused by lesions in the temporal and parietal lobes, it is most commonly associated with lesions in the occipital lobe 1).
What does quadrantanopia mean?
quadrantanopia. A loss of vision in a quarter of the visual field. The defect is usually bilateral as it is typically caused by a lesion past the optic chiasma.
What causes homonymous lower quadrantanopia?
A lower homonymous quadrantanopia describes the loss of the same upper quadrant from each visual field. Lower homonymous quadrantanopias are usually caused by damage to the optic radiation as it passes throught the parietal lobes.
Can quadrantanopia be cured?
Recovery is usually seen within the first 3-6 months if it is going to occur. Any field loss present after this time may be permanent. You may however feel that your sight improves as you adapt to the defect over time. Visual field loss cannot be cured if it does not spontaneously recover.
Can you drive with quadrantanopia?
This means that homonymous or bitemporal defects that come close to fixation, whether hemianopic or quadrantanopic, are not usually acceptable for driving.
Is quadrantanopia permanent?
Occasionally, patients will spontaneously recover vision in the affected field within the first three months after the brain injury; however, vision loss remaining after this period of spontaneous recovery is traditionally thought to be permanent, certain companies now claim to be able to induce recovery of vision ...
What causes unilateral quadrantanopia?
Conclusion : Unilateral quadrantanopia appears to have been caused by pituitary tumor with intratumor hemorrhage, or pituitary apoplexy, that compressed the posterior portion of optic chiasm upwards.
How do you say quadrantanopia?
0:051:01How To Say Quadrantanopia - YouTubeYouTubeStart of suggested clipEnd of suggested clip4 4 4 ante el pie 4 4 ante el pie 4.More4 4 4 ante el pie 4 4 ante el pie 4.
Why can I only see half of everything?
Hemianopia, sometimes called hemianopsia, is partial blindness or a loss of sight in half of your visual field. It's caused by brain damage, rather than a problem with your eyes.
What can cause visual field loss?
Causes of visual field defects are numerous and include glaucoma, vascular disease, tumours, retinal disease, hereditary disease, optic neuritis and other inflammatory processes, nutritional deficiencies, toxins, and drugs. Certain patterns of visual field loss help to establish a possible underlying cause.
What part of the brain causes homonymous hemianopia?
As for the areas of the brain most affected, 40% of homonymous hemianopsias originate in the occipital (rear) lobe of the cerebral hemisphere.
What causes unilateral quadrantanopia?
Conclusion : Unilateral quadrantanopia appears to have been caused by pituitary tumor with intratumor hemorrhage, or pituitary apoplexy, that compressed the posterior portion of optic chiasm upwards.
What causes left upper quadrantanopia?
This visual field defect is characteristic of damage to Meyer's loop on the left side of the brain. It can be associated with a lesion of an optic radiation. While quadrantanopia can be caused by lesions in the temporal and parietal lobes, it is most commonly associated with lesions in the occipital lobe.
What is Meyer's loop?
Meyer's loop constitutes the anteriormost extension of the optic radiation into the temporal horn. This pathway, its correlation with the temporal horn, and its implications for temporal lobe surgery are reviewed. Anatomy of the Visual Pathway.
What causes homonymous hemianopia?
What causes homonymous hemianopsia? The most common cause of this type of vision loss is stroke. However, any disorder that affects the brain — including tumors, inflammation and injuries — can be a cause.
What is homoonymous quadrantanopia?
Homonymous quadrantanopia. Homonymous implies the defect does not cross the vertical meridian. Homonymous describes defects that affect the same side of the vertical meridian (i.e., right or left side) of both eyes. Homonymous inferior quadrantanopia is a loss of vision in the same lower quadrant of visual field in both eyes whereas ...
What is the difference between inferior and superior quadrantanopia?
Homonymous inferior quadrantanopia is a loss of vision in the same lower quadrant of visual field in both eyes whereas a homonymous superior quadrantanopia is a loss of vision in the same upper quadrant of visual field in both eyes 3) .
What is the term for the damage to the optics of the temporal lobe?
A lesion affecting one side of the temporal lobe may cause damage to the inferior optic radiations (known as the temporal pathway or Meyer’s loop) which can lead to superior quadrantanopia on the contralateral side of both eyes (colloquially referred to as “pie in the sky”); if the superior optic radiations (parietal pathway) are lesioned, the visual loss occurs on the inferior contralateral side of both eyes and is referred to as an inferior quadrantanopia.
What causes a pie in the sky?
Contralateral superior quadrantanopia (“pie in the sky”) causes: Temporal lobe lesions. Lesions involving the lower bank of the calcarine fissure. Contralateral inferior quadrantanopia (“pie on the floor”) causes. Parietal lobe lesions such as infarction of the superior division of the middle cerebral artery.
What is the term for a defect in the visual field affecting a quarter of the field of vision?
Quadrantanopia. Quadrantanopia also called quadrantanopsia, refers to a defect in the visual field affecting a quarter of the field of vision. Quadrantanopia can be associated with a lesion of optic tract pathway. While quadrantanopia can be caused by lesions in the temporal and parietal lobes, it is most commonly associated with lesions in ...
Which lobe is the left half of the visual field processed in?
For example, information in the left half of visual field is processed in the right occipital lobe and information in the right half of the visual field is processed in the left occipital lobe 2). In a quadrantanopia that is partial, there also exists a distinct and sharp border between the intact and damaged field within the quadrant.
Which quadrant is inferior or superior?
Binasal or bitemporal quadrantanopia. Binasal (either inferior or superior) quadrantanopia affects either the upper or lower inner visual quadrants closer to the nasal cavity in both eyes. Bitemporal (either inferior or superior) quadrantanopia affects either the upper or lower outer visual quadrants in both eyes.
How to tell if you have quadrantanopia?
Symptoms related Quadrantanopia are as follows: Patient cannot see things clearly, have blurry vision or cannot see via a side of visual field (quarter part of eye) Patient may feel anxiety and most of the time is in anxious mood.
What is quadrantanopia stroke?
Quadrantanopia Stroke. Quadrantanopia is a condition associated with the temporal and parietal region of brain. It also involves the occipital lobe concerned with vision. Any kind of head injury or specific site injury regarding vision may lead to Quadrantanopia stroke.
How long does quadrantanopia take to recover?
Recovery of Quadrantanopia is totally depend upon the worsening of condition and patient’s will. Recovery from this condition is very slow that it may take years to recover but sometimes it does not take long to recover.
What causes vision loss in the quarter?
Any degenerative disease like epilepsy and seizures are also considered the main cause behind loss of vision in quarter part. Rupturing of arteries involved in circulation of blood also contribute toward the occurrence of this disease.
What is quadrant in visual field?
The word quadrant is used to define a specific area of visual field. Visual fields are divided into two hemispheres i.e. left and right and anopsia may occur in the upper or lower region of hemisphere i.e. superior and inferior region.
How to compensate for quadrantanopia?
Individuals with quadrantanopia often modify their behavior to compensate for the disorder, such as tilting of the head to bring the affected visual field into view. Drivers with quadrantanopia, who were rated as safe to drive, drive slower, utilize more shoulder movements and, generally, corner and accelerate less drastically than typical individuals or individuals with quadrantanopia who were rated as unsafe to drive. The amount of compensatory movements and the frequency with which they are employed is believed to be dependent on the cognitive demands of the task; when the task is so difficult that the subject's spatial memory is no longer sufficient to keep track of everything, patients are more likely to employ compensatory behavior of biasing their gaze to the afflicted side. Teaching individuals with quadrantanopia compensatory behaviors could potentially be used to help train patients to re-learn to drive safely.
What lobe is quadrantanopia in?
While quadrantanopia can be caused by lesions in the temporal and parietal lobes, it is most commonly associated with lesions in the occipital lobe.
What is the term for the damage to the optics of the temporal lobe?
A lesion affecting one side of the temporal lobe may cause damage to the inferior optic radiations (known as the temporal pathway or Meyer's loop) which can lead to superior quadrantanopia on the contralateral side of both eyes (colloquially referred to as "pie in the sky"); if the superior optic radiations (parietal pathway) are lesioned, the visual loss occurs on the inferior contralateral side of both eyes and is referred to as an inferior quadrantanopia.
Why is there a sharp border between the intact and damaged visual fields?
An interesting aspect of quadrantanopia is that there exists a distinct and sharp border between the intact and damaged visual fields, due to an anatomical separation of the quadrants of the visual field.
What is homonymous inferior quadrantanopia?
Homonymous inferior quadrantanopia is a loss of vision in the same lower quadrant of visual field in both eyes whereas a homonymous superior quadrantanopia is a loss of vision in the same upper quadrant ...
Which quadrant is inferior or superior?
Binasal/bitemporal quadrantanopia. Binasal (either inferior or superior) quadrantanopia affects either the upper or lower inner visual quadrants closer to the nasal cavity in both eyes. Bitemporal (either inferior or superior) quadrantanopia affects either the upper or lower outer visual quadrants in both eyes.
What is the term for the area of the field of vision that is lost in each eye?
The areas of the field lost in each eye are shown as black areas. This visual field defect is characteristic of damage to Meyer's loop on the left side of the brain. Quadrantanopia, quadrantanopsia, refers to an anopia affecting a quarter of the field of vision. It can be associated with a lesion of an optic radiation.
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What causes superior quadrantanopia?
Homonymous superior quadrantanopia is caused by damage to the contralateral inferior parts of the posterior visual pathway: the inferior optic radiation (temporal Meyer loop), or the inferior part of the occipital visual cortex below the calcarine fissure. [8][9] For normal visual acuity, you only need “half a macula”; hence, these patients have normal visual acuity.
What is the name of the condition that causes a deficit in the superior field of both eyes?
Homonymous superior quadrantanopia, also called “pie in the sky,” causes a field deficit in the superior field of both eyes for the same side. This visual field deficit is bilateral and involves retrochiasmal pathways. [1]
Can a V2 lesion cause quadrantic visual field defect?
A lesion involving the V2 and V3 extrastriate cortex may also cause a quadrantic visual field defect. [10] Bilateral superior quadrantanopsias, although rare, may occur for bilateral strokes or hemorrhages in both occipital lobes below the calcarine fissure. [9][11]
Can visual field deficits go unnoticed?
The presence of a mild visual field deficit may go unnoticed in a patient. However, severe superior quadrantanopia can cause significant loss of peripheral vision and can impede activities such as driving. The incidence of a visual field defect increases with age as the older population has an increased incidence of strokes and traumatic injuries. The prevalence of a visual field defect in the Australian population 49 years or older is 0.8%.[7] There is a statistically significant relationship between age, hypertension, diabetes, and renal insufficiency. However, only about half of the patients with visual defects had a history of stroke.
Is homonymous quadrantanopia a disease?
Superior homonymous quadrantanopia is not a disease; rather, a clinical finding that points towards a lesion of the optic radiations coursing through the temporal lobe. Scarce information is available regarding the frequency of this visual defect in the general population. However, studies documenting the frequency of a superior quadrantanopia following temporal lobe injury have been published.[6] The most common cause of the visual field defect is an ischemic stroke, comprising 69% of the cases. Most patients show homonymous hemianopia, but a third of the cases exhibit a superior quadrantanopia. Most lesions are localized in the occipital lobe, while 32% of lesions were found at the optic radiations.
Which lesion produces quadrantanopia?
Background: A lesion affecting the optic radiations may produce a quadrantanopia based on the topographical arrangement of the geniculocalcarine tract.
Which lobe is most likely to cause inferior quadrantanopia?
Results: Cerebrovascular disorders accounted for most lesions. The location (and frequency) of lesions causing inferior quadrantanopia was occipital lobe (76%), parietal lobe (22%), and temporal lobe (2%). Other localizing signs were associated with 6%, 89%, and 0% of lesions located in the occipital, parietal, and temporal lobes, respectively. The location (and frequency) of lesions causing superior quadrantanopias was occipital lobe (83%), parietal lobe (3%), and temporal lobe (13%). Other localizing signs were associated with 4%, 100%, and 0% of lesions located in the occipital, parietal, and temporal lobes, respectively.
Answers
Ischaemic stroke affecting the right occipital lobe, causing sudden onset isolated homonymous quadrantanopia in the left upper visual field. 1
Patient outcome
In accordance with European Stroke Organisation guidance for diagnostic investigation of embolic stroke, 10 the patient underwent Doppler ultrasonography, prolonged electrocardiography monitoring, and transoesophageal echocardiography; no cardioembolic origin was found. 6 11
Learning points
The presence of sudden onset bilateral homonymous quadrantanopia is a red flag for stroke in the occipital cortex or the optic radiation.
Footnotes
Competing interests: The BMJ has judged that there are no disqualifying financial ties to commercial companies. The authors declare the following other interests: none.
Overview
Quadrantanopia, quadrantanopsia, refers to an anopia affecting a quarter of the field of vision.
It can be associated with a lesion of an optic radiation. While quadrantanopia can be caused by lesions in the temporal and parietal lobes, it is most commonly associated with lesions in the occipital lobe.
Presentation
An interesting aspect of quadrantanopia is that there exists a distinct and sharp border between the intact and damaged visual fields, due to an anatomical separation of the quadrants of the visual field. For example, information in the left half of visual field is processed in the right occipital lobe and information in the right half of the visual field is processed in the left occipital lobe.
In a quadrantanopia that is partial, there also exists a distinct and sharp border between the inta…
Homonymous inferior/superior quadrantanopia
Homonymous denotes a condition which affects the same portion of the visual field of each eye.
Homonymous inferior quadrantanopia is a loss of vision in the same lower quadrant of visual field in both eyes whereas a homonymous superior quadrantanopia is a loss of vision in the same upper quadrant of visual field in both eyes.
A lesion affecting one side of the temporal lobe may cause damage to the inferior optic radiation…
Binasal/bitemporal quadrantanopia
Binasal (either inferior or superior) quadrantanopia affects either the upper or lower inner visual quadrants closer to the nasal cavity in both eyes. Bitemporal (either inferior or superior) quadrantanopia affects either the upper or lower outer visual quadrants in both eyes.
Compensatory behaviors
Individuals with quadrantanopia often modify their behavior to compensate for the disorder, such as tilting of the head to bring the affected visual field into view. Drivers with quadrantanopia, who were rated as safe to drive, drive slower, utilize more shoulder movements and, generally, corner and accelerate less drastically than typical individuals or individuals with quadrantanopia who were rated as unsafe to drive. The amount of compensatory movements and the frequency with …