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04-01-2011

#1

struggle

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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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04-01-2011

#2

harlesmd

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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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struggle (04-01-2011)
04-01-2011

#3

bronchiole

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C is the answer i guess.

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struggle (04-01-2011)
04-01-2011

#4

aktorque

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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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04-01-2011

#5

harlesmd

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Thanks dude for the effort writing this....this is high yield...

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aktorque (04-01-2011)
04-01-2011

struggle

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#6
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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.

04-01-2011

aktorque

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Quote:

Originally Posted by struggle

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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struggle (04-01-2011)
09-04-2011

usmle2011

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#8
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Quote:

Originally Posted by struggle

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 03:17 AM.

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09-04-2011

Amin Sabet

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D
(HY neuroanatomy)

09-04-2011

salz

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hmmm.. this is very high yield question

11-27-2011

saadke

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#11
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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