[Bilateral occipital infarction with central homonymous hemianopia].

A 45-year-old man of bilateral occipital infarction with central homonymous hemianopia is reported. He was admitted to our hospital with complaints of visual loss and large central scotoma on both eyes. Pupillary light reaction and ocular fundi were normal. On admission, bilateral retrobulbar optic neuritis was suspected. However, congruous, irregular central scotomas with vertical step were observed in both eyes with Goldmann perimetry. X-ray computed tomography (CT) and magnetic resonance imaging (MRI) revealed the infarction in bilateral occipital tips. Bilateral central homonymous hemianopia is considered to be rare and a case in which occipital lobe lesions were detected with X-ray CT and MRI has not been reported. We stress that bilateral central scotomas with vertical step indicate bilateral occipital lesions.