Middle cerebral artery strokes causing homonymous hemianopia: Positron emission tomography

Eight patients were evaluated with ¹⁸F‐fluorodeoxyglucose positron emission tomography between 3 and 30 days after isolated stroke involving the middle cerebral artery territory that caused homonymous hemianopia. Diffuse hypometabolism was present throughout the damaged cerebral hemisphere, even in cortical areas not obviously ischemic by clinical examination or neuroimaging. Glucose metabolism in primary and association visual cortex of the damaged hemisphere was decreased by more than 47% (p < 0.01). Metabolism in the undamaged hemisphere was less profoundly affected, but significant decrements were found in calcarine (40%;p < 0.01) and lateral occipital cortex (35%;p < 0.05).