Neurocysticercosis Presenting as Homonymous Hemianopia

Purpose: To report a case of occipital neurocysticercosis presenting as homonymous hemianopia. Case summary: A 52-year-old male with a history of frequent raw pork ingestion for 20 years presented with headaches, blurred vision, and a tingling sensation in the right side that worsened during the past two weeks prior to his visit. Visual acuity was 20/20 in both eyes. Humphrey automatic perimetry showed right homonymous hemianopia. Other ophthalmic examination results were unremarkable. Brain magnetic resonance imaging showed a large cystic mass with ring enhancement in the left occipital lobe, and several small parenchymal cysts in the right hemisphere. A serologic test for neurocysticercosis with cerebrospinal fluid was positive. He was treated with al bendazole and steroid for two weeks, but the visual symptoms persisted. Craniotomy and removal of the cystic lesion were performed, and the visual field improved. Conclusions: Symptomatic neurocysticercosis is rare, but it can be presented as homonymous hemianopia. Occipital lobe neurocysticercosis should therefore be considered when examining any patient with a visual field defect and a history of raw pork ingestion.