Post-cardiac Catheterization Bilateral Posterior Cerebral Artery Cardioembolic Stroke Causing Anton Syndrome
Michelle Nabi1, Bahadar Srichawla2
1Internal Medicine, 2Neurology, University of Massachusetts Chan Medical School
Objective:
We present a case of a 76-year-old woman who developed Anton syndrome after a left heart catheterization.
Background:
Anton syndrome, described as visual anosognosia associated with confabulation in the setting of cortical blindness, is a rare phenomenon to occur post-cardiac catheterization.
Design/Methods:
A case-study of a 76-year-old woman is presented following the CARE guidelines.
Results:
The patient was admitted to the hospital for an NSTEMI and underwent a left heart catheterization using 50 cc of contrast used for diagnostic imaging. One hour post-procedure, she developed bilateral vision loss and started to confabulate her surroundings. A code stroke was activated and a head computed tomography showed no acute intracranial bleed. Tissue plasminogen activator (tPA) was not given due to an elevated partial thromboplastin time (PTT). A CT angiogram of the head and neck revealed significant atherosclerotic disease involving the aortic arch and innominate arteries. Magnetic resonance imaging (MRI) revealed bilateral infarcts in the territory of the posterior cerebral artery (PCA), as evidenced by diffusion-weighted imaging (DWI) and apparent diffusion coefficient (ADC) mapping. She was believed to have suffered from a rare bilateral PCA cardioembolic stroke.
Conclusions:
Her vision returned spontaneously within 24 hours and she no longer was confabulating. She was recommended to start aspirin 81 mg and a high-intensity statin. A search of the current literature reports Anton Syndrome post-cardiac catheterization is a rarely encountered complication.