Sight lost, insight kept: Cortical blindness without visual anosognosia after bilateral occipital infarcts: A case report.
- Author:
John Lorenze C. DATINGUINOO
;
Vicente G. ROSALES JR.
;
Johnny K. LOKIN
- Publication Type:Case Report
- Keywords: Bilateral Visual Loss; Bilateral Cortical Blindness; Bilateral Occipital Stroke; Anton’s Syndrome; Case Report
- MeSH: Human; Male; Aged: 65-79 Yrs Old; Cardioembolic Stroke; Embolic Stroke; Stroke
- From: Philippine Journal of Neurology 2025;28(2):14-21
- CountryPhilippines
-
Abstract:
Cortical blindness, a consequence of bilateral occipital lobe lesions, typically manifests with partial or complete visual loss. It is often associated with the intriguing phenomenon of visual anosognosia, wherein patients paradoxically deny their profound visual loss, which would often lead to confabulation. This constellation of clinical findings points to Anton’s Syndrome. Bilateral occipital infarcts are the most common cause of cortical blindness, and the cooccurrence of visual anosognosia is frequently reported in these cases. We present a unique case of a 65-year-old right- handed Filipino male who experienced sudden, acute cortical blindness resulting from simultaneous bilateral occipital infarcts of likely cardioembolic origin secondary to atrial fibrillation. Despite the cortical blindness, the patient explicitly acknowledged his blindness and was not demonstrating signs of denial or confabulation. The patient’s neurological examination was otherwise notable only for the visual impairment, without other focal deficits. This clinical presentation stands in contrast to the typical features of Anton's syndrome. Cranial magnetic resonance imaging revealed acute infarcts in both occipital lobes and the right pons. This unusual presentation underscores the heterogeneity in the clinical expression of posterior circulation strokes. This case contributes valuable insights into the complex neural pathways involved between visual information processing, its awareness, and speech production following bilateral occipital infarction. This is the Philippines’ unprecedented case of bilateral visual loss after simultaneous acute bilateral occipital infarcts occurring without accompanying visual anosognosia.