An Unrecognized Symptom of Brain Tumors in the Emergency Department: Left Homonymous Hemianopsia

Abstract

Patients with a mass or ischemic lesion on the visual pathways cannot avoid obstacles on the affected side in accordance with the localization of the lesion and may collide with approaching people and obstacles. In this case, we wanted to draw attention to the case with homonim hemianopsy and diagnosed with glioblastoma in the visual field examination based on the history of headaches and recurrent trauma. A 52-year-old male patient applied to the emergency department with the complaints of hitting objects on his left side and hitting the left side of his car twice in the past week. Left homonymous hemianopsia was detected in the visual field examination of the patient. On CT imaging, a mass with diffuse peripheral edema were observed in the right occipitoparietal. The patient was admitted to the neurosurgery department. The patient was operated 1 day after hospitalization and his pathology result of the lesion was compatible with glioblastoma. Visual fields provide valuable information about the location of brain lesions, especially when associated with other symptoms. The anamnesis of patients with these complaints should be examined in detail. These patients may not be aware of their visual impairment. Therefore, routine visual field examination should be performed in the neurological evaluation of the patients.

Keywords

• glioblastoma multiforme
• hemianopsia
• visual field examination.