DrMKZ

This was the most interesting neurology case I have ever seen.

I saw this middle age man last night. He was walking well unaided with his beloved wife and a child.

I was wondering what could this man having ?

Apparently , he had done bypass surgery in 2007, and he came to ED with a very peculiar complaints.
I have never heard this complaint before.

” Anak, pak cik tak boleh kenal huruf 2, 3 hari ni! ” I was thinking may be he was illiterate or something, but he wore this nice crocodile shirt and a well groomed hair.
Contradicting to the bypass – must be some rich guy.

Then he continued ” Bila saya baca awak nak pergi mane? I only see the awak dot dot mane? Blank in between! dan saya kena pusing kepala ! ” ” Bila kat ATM, saya dah tekan 200, tapi saya tak kenal 200 ” ” saya ada accident the car on the right side ”

I was thinking, this is a very interesting complaint. – A rare complaint–

” Pakcik tak de lemah badan ke? ” I tried  to narrow down my differentials

” Ada ! tapi dekat bahagian muka je dik ! ”

I was pretty this is some- kind of a stroke.

Physically, he was walking, no act of falling down, no eye problem

I sent an urgent CT

And wallah!!

There you go. A lesion well defined, hypodense at the left occipito- parietal.

Very interesting case.

I think he might just have  this very clasical homonymous hemianopia.