Anton Syndrome Following Recurrent Hemorrhagic Stroke: A Case Report

Anton syndrome is a rare neurobehavioral manifestation of cortical blindness characterized by visual anosognosia and, frequently, visual confabulation.We describe a case of a 61-year-old man with a history of hypertension and three previous hemorrhagic strokes who presented with headache and vomiting.Examination revealed profound bilateral visual loss with preserved pupillary light reflexes and object recognition only by touch, consistent with cortical blindness.Brain computed tomography revealed an acute right parieto-occipital hemorrhage with mass effect and chronic left posterior encephalomalacia.Early neurological deterioration with new motor deficits, increasing edema, and mass effect prompted urgent right occipital craniotomy with partial hematoma evacuation.During postoperative assessment, he stated that he could see despite absent bilateral blink-to-threat responses and inaccurate descriptions of visually presented objects.These responses were documented while he could answer basic orientation questions and follow simple commands, supporting a clinical diagnosis of Anton syndrome.Subsequent follow-up documented increasing independence in daily activities with persistent visual impairment clinically described as tunnel vision.This case illustrates how an acute right parieto-occipital hemorrhage may precipitate cortical blindness and Anton syndrome when superimposed on chronic contralateral posterior cerebral injury, underscoring the importance of assessing visual awareness separately from visual performance.