Left Homonymous Hemianopia Mimicking Spatial Neglect in Right Middle Cerebral Artery Territory Infarction

Homonymous hemianopia, typically associated with posterior cerebral artery (PCA) infarction, can occur in middle cerebral artery (MCA) infarction involving the optic radiations. We report a 53-year-old man with right MCA infarction. After dysarthria and left-sided weakness improved, he developed gait deviation and neglect-like behavior. He was diagnosed with left homonymous hemianopia by visual field testing and automated perimetry and follow-up imaging showed no new PCA infarction. This case highlights the importance of visual field examination in MCA infarction.