Case of 15-year-old boy with left-hand homonymous hemianopsia

Aim: In our study we analyse in detail the case of a 15- year-old boy with homonymous hemianopsia. The purpose of this study is to emphasize the importance of brain perfusion SPECT in differential diagnosis of neurological diseases and a possibility of incidence of serious children's brain ischemia. Methods: We analyse in detail the diagnostic method in detection and definitive diagnosis with stress an imaging methods. An integral part of the poster is picture documentation including 99mTc HMPAO SPECT using the double head camera PRISM 200 VP with LEHR collimator. The scintigraphic data were evaluated by the visual and semiquantitative analysis. Results: As early as at the beginning of the diagnostic method HMPAO SPECT of the brain was made and already here we drew attention to great probability of (luxurious) hyperperfusion in the ischemic zone in the right occipital lobe including the visual centre. Taking into consideration normal CT and MRI findings, an atypical course of herpetic encephalitis was considered and only on the second place an ischemic stroke. Conclusion: The case was concluded definitively as the state after an ischemic stroke in the area of arteria cerebri posterior l. dx. Apart from other facts mutation f V. Leiden - heterozygote and other congenital trombophilia state was found out - mutation of the gene for methyltetrahydrofolate reductase (heterozygote). Combination of two congenital trombophilic states could play its role in etiopatogenesis of the acute ischemic stroke. Brain perfusion SPECT helped significantly to determine the diagnosis