Disclosures: Jaskiran Ghuman, DO: No financial relationships or conflicts of interest
Case Description: This case explores lesions involved in visuospatial awareness
Setting: Inpatient acute and outpatient rehabilitation
Patient: 31 year old Male PMH asthma was admitted for anoxic brain injury after cardiac arrest and NSTEMI secondary to myocarditis likely induced by exogenous steroid use. Assessment/
Results: In inpatient rehabilitation the patient was limited to a MET of 5 per Cardiology. Occupational Therapy and Ophthalmology had diagnosed a right lower homonymous quadrantanopia. Neuropsychology found difficulty in the following cognitive domains: executive functioning, working and delayed memory, visual reproduction, visuospatial awareness, and language. An AICD prohibited MRI imaging. The patient was discharged home with outpatient follow up.
Discussion: Despite improvement in the patient’s homonymous quadrantanopia documented by the King-Devick Test, the patient scored in the first percentile in the Rivermead Behavioral Memory Test with significant deficits in visuospatial performance. The patient’s visuospatial processing and memory skills were further assessed with Rey-Osterrieth Complex Figure Test in which the patient scored in the 10th percentile. The patient’s homonymous quadrantanopia is likely from lesions in any of the following locations: occipital lobes, optic radiation, optic tract, lateral geniculate nucleus. The patient showed recovery of his vision but not his visuospatial performance or memory. It is well documented that the hippocampus may be affected in anoxic injuries as it is very sensitive to hypoxic changes. The clinical history supports failure of the patient’s working memory as he experiences frequent anterograde amnesia in both the work and home environment; however, he is pending further testing by Neuropsychology.
Conclusion: We may possibly extrapolate from this patient that visuospatial perception is a function heavily integrated by the hippocampus. When anterograde amnesia is identified, specialized occupational therapists with advanced training in vision therapy should be integrated to fully assess patients with anoxic injuries for visuospatial deficits.
Level of Evidence: Level V
To cite this abstract in AMA style:
Ghuman J, Tamarkin R, Patel P, Ramroop H, Isaacson A. Visuospatial Deficits and Anterograde Amnesia in the Setting of Resolving Homonymous Quadrantanopia [abstract]. PM R. 2020; 12(S1)(suppl 1). https://pmrjabstracts.org/abstract/visuospatial-deficits-and-anterograde-amnesia-in-the-setting-of-resolving-homonymous-quadrantanopia/. Accessed June 6, 2025.« Back to AAPM&R Annual Assembly 2020
PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/visuospatial-deficits-and-anterograde-amnesia-in-the-setting-of-resolving-homonymous-quadrantanopia/