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@#This a case report on a rare case of denial of visual perception termed as inverse Anton syndrome. It is a rare extension of perception without awareness in which, specific brain lesions affected a patient’s visual abilities. A 66-year-old Malay gentleman presented with sudden onset of the painless bilateral total loss of vision with expressive aphasia for 2 days. His visual acuity was 6/12 in the right eye and 6/48 in the left eye. However, he was insistent that he could not see but did not request any form of assistance for his blindness. He also had neurological signs suggestive of parietal lobe syndrome. Brain imaging showed subacute left middle cerebral artery territorial infarct with no occipital lobe involvement. The denial of visual perception by this patient may be explained by a disconnection of parietal lobe attentional systems from visual perception
RESUMO
Introduction: Anton’s syndrome is a condition where the patient is unaware of being blind and denies the problem even when it is pointed out to him. On the contrary, in cortical blindness patient is aware of his blindness and does not deny it. In both, bilateral lesions of the occipital lobes are seen. Case presentation: We present two cases of cortical blindness, Case 1 being consistent with diagnosis of Anton’s syndrome where patient denied of her blindness. Both cases revealed bilateral occipital lobe infarcts. Conclusions: Cerebrovascular disease is the most common cause of cortical blindness. These occur as a result of successive infarctions as seen in Case 1 or from a single embolic or thrombotic occlusion as seen in Case 2. First case is Anton’s syndrome with patient denying blindness, whereas second case is cortical blindness. It is due to involvement of other cortical centers in Anton’s syndrome that patient denies blindness.
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Las manifestaciones clínicas del ACV son muy variables, no sólo la clásica hemiplejia facio-braquio-crural, déficit sensitivo contralateral y afasia, sino que también puede presentarse, en menos frecuencia, por déficit neurológicos de variada índole, tal es el caso del síndrome de Anton, en que debido a un afección del territorio cortical visual primario bilateral (área 17 de Brodmann) y al área de asociación vecina, caracterizado por ceguera cortical y anosognosia. Comunicamos el caso de un hombre que presenta este síndrome, que debido a dos ACVs, uno antiguo y otro reciente, cuyo diagnóstico fue confirmado por TAC de cerebro.
Clinical manifestations of stroke are highly variable, not only the classic hemiplegia facio-brachio-crural, contralateral sensory loss and aphasia, but can also occur, less frequently, neurological deficits of various kinds, as in the case of the syndrome in Anton, a condition that due to the territory bilateral primary visual cortex (Brodmann area 17) and the neighboring association area, characterized by cortical blindness and anosognosia. We report the case of a man who has this syndrome, due to two LCAs, one old and one recent, whose diagnosis was confirmed by brain CT.