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We describe a 48\u2010year\u2010old woman presenting with a sudden onset of scintillating scotoma and left\u2010lower quadrantanopsia. Hyperacute cerebral infarction was suspected. However, brain magnetic resonance imaging (MRI) revealed a mass at the cortico\u2010medullary junction in the right occipital lobe. We diagnosed her as metastatic melanoma. We suspected that neurological deficits can be attributed to seizure, and therefore introduced levetiracetam. She showed neurological improvement immediately. Our case demonstrated the importance of considering brain tumor as a differential diagnosis in patients presenting with acute\u2010onset neurological deficits. In addition to appropriate treatment of tumor, the use of newer antiepileptic drugs resulted in good neurological prognosis in metastatic brain tumors.<\/jats:p>","DOI":"10.1002\/jgf2.301","type":"journal-article","created":{"date-parts":[[2020,2,11]],"date-time":"2020-02-11T11:42:17Z","timestamp":1581421337000},"page":"77-79","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["A central nervous system metastasis of melanoma with stroke\u2010like onset of left\u2010lower quadrantanopsia"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9336-1168","authenticated-orcid":false,"given":"Akira","family":"Arakawa","sequence":"first","affiliation":[{"name":"Department of Neurology Tokyo Teishin Hospital Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akihiko","family":"Mitsutake","sequence":"additional","affiliation":[{"name":"Department of Neurology Tokyo 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