Simultanagnosia as the presenting symptom in neuro-ophthalmology.

Simultanagnosia is a well-known neurologic symptom characterized by the inability to conceptualize the whole picture despite being able to see individual elements within a visual scene. The pathophysiology involves a lesion to the bilateral parieto-occipital lobe. We report two unusual cases of simultanagnosia and juxtaposed homonymous visual field loss involving aqueductal stenosis-related obstructive hydrocephalus and cardiac arrest due to Brugada syndrome. Clinicians should be aware that simultanagnosia can be the presenting symptom of neuro-ophthalmic disease.