A patient describes a history of a "curtain being brought down over my right eye it stayed there for a few minutes then was lifted back up." In which of the following arteries is the etiology of this complaint located?
- anterior cerebral
- middle cerebral
- posterior cerebral
- internal carotid
- external carotid
Answer: D
Internal Carotid
This is amaurosis fugax: transient monocular vision loss described as a curtain coming down over one eye. It is a form of transient ischemic attack (TIA) in the retinal circulation, usually from an embolus arising from the internal carotid artery, which gives off the ophthalmic artery (the retinal blood supply). Patients need urgent carotid imaging.
By contrast, a posterior cerebral artery stroke affects the occipital cortex and causes a contralateral homonymous hemianopia (the same half of the visual field lost in both eyes), not monocular vision loss. Only bilateral occipital infarcts cause complete (cortical) blindness.
Know Your Content Blueprint
Retinal vascular occlusion is covered in the NCCPA™ EENT Content Blueprint (9%)
Review Topic: Retinal vascular occlusion