安东-巴宾斯基综合征是一种罕见的疾病,表现为双侧皮质盲和视觉虚构的失认症,但没有痴呆或任何记忆障碍.它具有独特的神经精神表现,对于那些视力丧失和枕叶损伤的影像学证据的人,应高度怀疑。在这里讨论的情况下,一名90岁的男子出现双侧失明,明显的失认症,生动的视觉虚构,他已经吃了3天了。脑计算机断层扫描显示双侧枕叶最近发生低密度梗死。因此,患者被诊断为Anton-Babinski综合征。由于他的年龄和在缺血性中风后黄金3小时内的溶栓治疗,患者接受阿司匹林治疗,而非组织型纤溶酶原激活剂或华法林.在接下来的一周里,他逐渐意识到自己是盲人,但1个月后死于肺炎。在文学中,安东-巴宾斯基综合征患者很难建立失明意识,但乐观地说,在一份报告中,一名患者在两周内意识到失明,没有视力改善。我们的病例说明,患有安东-巴宾斯基综合征的老年患者可以部分康复,并且1周是视力没有改善的患者建立失明意识的最短时间。
Anton-Babinski syndrome is a rare disease featuring bilateral cortical blindness and anosognosia with visual confabulation, but without dementia or any memory impairment. It has a unique neuropsychiatric presentation and should be highly suspected in those with odd visual loss and imaging evidence of occipital lobe injury. In the case discussed herein, a 90-year-old man presented with bilateral blindness, obvious anosognosia, and vivid visual confabulation, which he had had for 3 days. Brain computed tomography demonstrated recent hypodense infarctions at the bilateral occipital lobes. Thus, the patient was diagnosed with Anton-Babinski syndrome. Because of his age and the thrombolytic therapy during the golden 3 hours after ischemic stroke, the patient received aspirin therapy rather than tissue plasminogen activator or warfarin. He gradually realized he was blind during the following week, but died of pneumonia 1 month later. In the literature, it is difficult to establish awareness of blindness in patients with Anton-Babinski syndrome, but optimistically, in one report, a patient was aware of blindness within 2 weeks, without vision improvement. Our case illustrates that elderly patients with Anton-Babinski syndrome can partially recover and that 1 week is the shortest time for the establishment of awareness of blindness for sufferers without vision improvement.