Lateral geniculate body infarction

Case contribution: Dr Radhiana Hassan

Clinical:

  • A 45 years old man
  • No known underlying illness
  • Presented with reduced sharpness of vision bilaterally for 2 months
  • No other symptoms.
  • Clinical examination shows normal vital signs.
  • Visual acuity is normal. Homonymous hemianopia detected.
  • No other neurological deficit.

 

MRI findings:

  • A small well-circumscribed lesion¬† is identified at the right corona radiata adjacent to the occipital horn of the right lateral ventricle, at the region of right lateral geniculate body.
  • It appears hypointense on T1, hyperintense on T2 and suppressed on FLAIR with rim hyperintesity surrounding it. No enhancement post IV Gadolinium is detected.
  • No restricted diffusion on DWI and ADC map images.
  • This is in keeping with small lacunar infarction.
  • Multiple lesions with T2/ FLAIR high signal intensity are seen within deep white matter at bifrontal lobes including bilateral periventricular regions most likely due to¬† small vessel ischemia (images not shown).

Diagnosis: Infarction of right lateral geniculate body

Discussion:

  • The lateral geniculate body is on the anterior third of the visual pathway.
  • A lesion on this nucleus produce moderately to completely congruent visual field defect.
  • Visual symptoms include a wedge-shaped homonymous hemianopia, congruent superior homonymous quadratic defect and alos a quadraple sector defect.
  • The lateral geniculate body has a dual blood supply from the anterior choroidal artery (branch from ICA) and from the lateral choroidal artery (branch from PCA)
Author: radhianahassan