Maddula Mohana, Lutton Stuart, Keegan Breffni
Stroke Unit, Erne Hospital, Cornagrade Road, Enniskillen BT74 6AY, UK.
J Med Case Rep. 2009 Sep 9;3:9028. doi: 10.1186/1752-1947-0003-0000009028.
Anton's syndrome describes the condition in which patients deny their blindness despite objective evidence of visual loss, and moreover confabulate to support their stance. It is a rare extension of cortical blindness in which, in addition to the injury to the occipital cortex, other cortical centres are also affected, with patients typically behaving as if they were sighted.
We present a case report of an 83-year-old white woman with cortical blindness as a result of bilateral occipital lobe infarcts. Despite her obvious blindness, illustrated by her walking into objects, the patient expressed denial of visual loss and demonstrated confabulation in her accounts of her surroundings, consistent with a diagnosis of Anton's syndrome.
A suspicion of cortical blindness and Anton's syndrome should be considered in patients with atypical visual loss and evidence of occipital lobe injury. Cerebrovascular disease is the most common cause of Anton's syndrome, as in our patient. However, any condition that may result in cortical blindness can potentially lead to Anton's syndrome. Recovery of visual function will depend on the underlying aetiology, with cases due to occipital lobe infarction after cerebrovascular events being less likely to result in complete recovery. Management in these circumstances should accordingly focus on secondary prevention and rehabilitation.
安东综合征描述的是这样一种情况,即患者尽管有视力丧失的客观证据,但仍否认自己失明,而且还会虚构情节来支持自己的立场。它是皮质盲的一种罕见延伸,除枕叶皮质受损外,其他皮质中枢也受到影响,患者通常表现得好像他们有视力一样。
我们报告一例83岁白人女性因双侧枕叶梗死导致皮质盲的病例。尽管她明显失明,比如走路时会撞到物体,但患者否认视力丧失,并在描述周围环境时表现出虚构,符合安东综合征的诊断。
对于有非典型视力丧失且有枕叶损伤证据的患者,应考虑皮质盲和安东综合征的可能性。正如我们的患者一样,脑血管疾病是安东综合征最常见的病因。然而,任何可能导致皮质盲的情况都有可能引发安东综合征。视觉功能的恢复将取决于潜在病因,脑血管事件后因枕叶梗死导致的病例不太可能完全恢复。在这种情况下,管理应相应地侧重于二级预防和康复。