Which type of stroke typically results in contralateral homonymous hemianopsia?

The occurrence of contralateral homonymous hemianopsia, which is the loss of half of the visual field in both eyes on the same side, is most commonly associated with a stroke affecting the middle cerebral artery. This type of stroke can lead to visual field deficits due to the involvement of the optic radiation, which runs near the lateral aspects of the cerebral hemispheres supplied by the middle cerebral artery.

In the case of a middle cerebral artery stroke, the optic radiation fibers that carry visual information from the lateral geniculate nucleus to the visual cortex can be damaged. Since these fibers are organized such that they represent visual fields contralaterally, damage here can result in the corresponding loss of vision on the opposite side of the visual field, hence causing contralateral homonymous hemianopsia.

Other types of strokes may also result in visual field changes, but they do not specifically lead to this particular pattern of hemianopsia as consistently as the middle cerebral artery strokes do. For example, while a hemorrhagic stroke or strokes in the anterior cerebral artery might lead to various deficits, they typically do not produce this specific visual field impairment. Distal cerebral strokes might affect different territories, likely leading to more diffuse or different types of deficits