[vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” oblique_section=”no” text_align=”left” css_animation=””][vc_column][ultimate_heading main_heading=”Candidate brief” main_heading_color=”#000000″ sub_heading_color=”#000000″ main_heading_style=”font-weight:bold;” main_heading_font_size=”desktop:36px;”]

“This patient has complained of visual problems.  Please examine their visual fields and discuss your findings with the examiners.”

[/ultimate_heading][vc_empty_space image_repeat=”no-repeat”][vc_video link=”https://vimeo.com/156168849″][vc_empty_space image_repeat=”no-repeat”][vc_row_inner row_type=”row” type=”full_width” use_row_as_full_screen_section_slide=”no” text_align=”left” css_animation=””][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Station Time” counter_value=”20″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Time for this encounter” counter_value=”10″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Maximum time to examine your patient” counter_value=”6″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][vc_column_inner width=”1/4″][stat_counter icon_size=”32″ counter_title=”Minimum time for discussion and questions” counter_value=”4″ counter_suffix=” minutes” speed=”3″][/vc_column_inner][/vc_row_inner][vc_empty_space image_repeat=”no-repeat”][/vc_column][/vc_row][vc_row row_type=”row” use_row_as_full_screen_section=”no” type=”full_width” oblique_section=”no” text_align=”left” css_animation=””][vc_column][vc_accordion style=”accordion”][vc_accordion_tab title=”Common examiner questions”][vc_column_text]Common examiner questions include the following:

  1. What do you think this patient has?
  2. How would you like to investigate this patient next?
  3. What do you think the underlying cause of this patient’s signs is?

[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Diagnosis and clinical signs”][vc_column_text]This patient has a left homonymous hemianopia.[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Discussion”][vc_column_text]This is caused by lesions affecting the optic tract that are served by the entire communicating artery. The most common type of stroke is a PACS (partial anterior circulation stroke 35%) and the a TACS (total anterior circulation stroke – 20%). The latter is caused by damage to the proximal arm of the internal carotid artery or middle cerebral artery; while the former is due to damage any one of the branches of the middle cerebral artery.

The causes are of a lesion in the contralateral parietal or temporal radiations of the optic nerve caused by a TACS or PACS.

For a TACS, a contralateral hemiparesis of at least two of the following three – leg, arm or face; contralateral homonymous hemianopia or quadrantopia and an abnormality of the higher cortical dysfunction such as dysphasia.
For a PACS, which is the most common, this requires two out of the following three criteria to be met: contralateral weakness of the arm OR leg OR hand or part thereof; higher cortical dysfunction such as dysphasia or neglect and the afore mentioned visual field defects, which are not as common in PACS if the middle cerebral artery upper portion is damaged.

Other ocular features to look for include a supra nuclear facial palsy as well as the afore mentioned upper motor neurone signs in the contralateral-to-lesion side of the body.[/vc_column_text][/vc_accordion_tab][vc_accordion_tab title=”Specimen case presentation”][vc_column_text]”This patient has a left homonymous hemianopia suggesting a lesion in the optic radiation.”[/vc_column_text][/vc_accordion_tab][/vc_accordion][/vc_column][/vc_row]