Transient Monocular Vision Loss TMVL

A 64-year-old man presented to an emergency department because of 20 minutes of a visual disturbance in his right eye that developed that morning as he was sitting and speaking with a friend. He described a graying of my vision that started superiorly in the right eye and descended over several seconds to the horizontal meridian. He had difficulty distinguishing his friend's features from the neck up (or any other details in his superior field for that matter). He closed one eye at a time, and...

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This patient has vascular dementia due to chronic microvascular disease. This entity, described originally by Otto Binswanger, a German pathologist, is characterized pathologically by multiple lacunar infarcts and confluent areas of soft, puckered, and granular tissue in the cerebral and cerebellar white matter. The white matter lesions are patchy and predominantly affect the periventricular white matter, especially anteriorly and close to the surface of the ventricles. The volume of white...