Dr. Arnab Pal

Dr. ANURADHA CHANDRA

Abstract

A 25 year old male patient presented to the OPD with gradually increasing headache and dimness of vision in both eyes inspite of using glasses.All examination revealed normal findings except bilateral disc pallor.IOP,NPA and NPC values were normal.However AP 30-2 revealed highly congruous left homonymous hemianopsia.Hence MRI Brain with contrast was ordered which revealed a huge right occipital bleed.Subsequently MRA Brain revealed right occipital AVM(arteriovenous malformation).Patient was referred to neurosurgeon where endoscopic embolization of AVM was done.Regular follow ups over next few years showed minimal residual occipital bleed with a non progressing hemianopsia.Hence this case drives home the importance of automated perimetry in all cases of unexplained headaches wherein migraine must be considered as diagy of exclusion.