Bosphorus Med J. 2022; 9(3): 195-198 | DOI: 10.14744/bmj.2022.68442

Acil Serviste Beyin Tümörlerinin Tanýnmayan Bir Semptomu: Sol Homonim Hemianopsi

Yunus Emre Saðmal, Merve Ekþioðlu, Tuba Cimill Ozturk
Fatih Sultan Mehmet Eðitim ve Araþtýrma Hastanesi, Acil Týp Kliniði, Ýstanbul, Türkiye

Görme yollarý üzerinde kitle veya iskemik lezyonu bulunan hastalar, lezyonun lokalizasyonuyla uyumlu olarak etkilenen taraftaki engellerden kaçýnamazlar, yaklaþan insanlara ve engellere çarpabilirler. Bu olgu sunumunda, baþ aðrýsý ve tekrarlayan travma öykülerinden yola çýkýlarak yapýlan görme alaný muayenesinde homonim hemianopsisi olan ve glioblastoma tanýsý alan olguya dikkat çekilmek istendi. Elli iki yaþýnda erkek hasta, son bir haftadýr sol tarafýndaki nesnelere çarpma ve arabasýnýn sol yanýný iki kez vurma þikayetiyle acil servise baþvurdu. Hastanýn görme alaný muayenesinde sol homonim hemianopsi tespit edildi. Bilgisayarlý tomografi görüntülemesinde sað oksipitopariyetalde yaygýn periferik ödemin eþlik ettiði kitle izlendi. Hastanýn beyin cerrahisi bölümüne yatýþý yapýldý. Yatýþýndan bir gün sonra opere edilen hastanýn patoloji sonucu glioblastoma ile uyumlu bulundu. Görme alanlarý, özellikle diðer semptomlarla iliþkilendirildiðinde, beyin lezyonlarýnýn yeri hakkýnda deðerli bilgiler saðlar. Bu þikayetler ile gelen hastalarýn anamnezi derinleþtirilmelidir. Bu hastalar görme kusurlarýnýn farkýnda olmayabilir, bu nedenle hastalara nörolojik deðerlendirmede rutin görme alaný muayenesi mutlaka yapýlmalýdýr.

Anahtar Kelimeler: Glioblastoma multiforme, görme alaný muayenesi, hemianopsi.

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

Yunus Emre Saðmal, Merve Ekþioðlu, Tuba Cimill Ozturk
Fatih Sultan Mehmet Training and Research Hospital, Emergency Medicine Clinic, Istanbul, Türkiye

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.

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ATIF KOPYALA