(3,4) The subsequent neurologic deficits can manifest as partial or complete hemiparesis,
homonymous hemianopsia, Horner's syndrome, facial nerve paralysis, gait issues, or death.
Examination was unremarkable, except for a left
homonymous hemianopsia. At the time, hormonal analysis was as follow; prolactin (PRL) levels 16,980 ng/ml (nl <25 ng/ml), fasting growth hormone (GH) 1.3 ng/ml (nl <5 ng/ml), luteinizing hormone (LH) 1.72 mIU/ml (n16-23 mIU/ml), follicle stimulating hormone (FSH) 2.19 mIU/ml (n14-25 mIU/ml), free T4 6.2 mcg/ dl (nl 5-12 mcg/dl) and morning cortisol 0.63 mcg/dl (nl 5-30 mcg/dl).
(1,2,4) Examples of previously reported presentations include cranial nerve palsies, (5,6) dysphagia, (7)
homonymous hemianopsia, (8) seizures, (9,10) and obstructive hydrocephalus, (2,11-13) as in the current case.
Evaluation of the visual fields showed left
homonymous hemianopsia. All other neurologic assessments were unremarkable.
Contralateral
homonymous hemianopsia is the usual symptom associated with superficial occlusion of a PCA.
Neurologic examination at the time of psychiatric consultation is notable for waxing and waning expressive aphasia, right
homonymous hemianopsia, and mildly decreased strength in the left biceps and forearm.
Robert opened his eyes spontaneously, had a right
homonymous hemianopsia and bilateral facial weakness.
On neurologic examination, the patient had a right
homonymous hemianopsia, optic nerve atrophy, and major visual impairment (left eye--20/100; right eye--20/200).
In most cases, there is bilateral improvement following a unilateral lesion, although contralateral improvement is greater.[25,11,18]
Homonymous hemianopsia is the most emphasized complication,[25] because of the close proximity of the pallidal lesions to the optic tract, but its incidence has been reduced by improved stereotactic techniques.[18] Optimum candidates for VP are those with akinesia partially responsive to medication, bradykinesia with freezing during repetition, asymmetrical severe rigidity, or frequent disabling dyskinesia.[11,18]