Bilateral superior altitudinal hemianopia: missing the goal, but hitting the stroke cause.

Bilateral superior altitudinal hemianopia is an uncommon clinical presentation of ischemic stroke. We report a patient who had an ischemic stroke with a pure bilateral superior altitudinal hemianopia resulting from bilateral ischemia in the optic radiation. This symptom was first overlooked and a delusion was suspected. A thorough clinical examination is essential to avoid any misdiagnosis or to overlook correct treatment.