C4.005 - Bilateral PCA infarct with Vertebral artery stenosis

Case not moderated.

79 year old male with history of loss of consciousness 2 weeks earlier. Also had altered sensorium for 2 days. He had a history of giddiness for 3 months. He had transient visual blurring 2 times in 3 months.
On examination, BCVA 6/6p, 6/9p, pupils sluggish to light OU, Ocular movements full, no diplopia
Fundus- BE disc margin irregular, b/l disc pallor, c/d 0.6, 0.4

Visual FIeld

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Right incomplete congruous hemianopia.

Visual Field

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Left complete homonymous hemianopia

MRI

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Axial T1W MRI brain - Bilateral occipital infarct, with larger infarct on right side as compared to the left side.

MRA

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MRA Brain - Left vertebral artery stenosis

Visual Fields

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On followup after 6 months, the Humphrey Visual fields showed Right incongruous Pie in the sky.

Visual Fields

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On followup after 6 months, the Humphrey Visual fields showed Left Pie in the floor

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