Preserved evoked conscious perception of phosphenes with direct stimulation of deafferented primary visual cortex

The premise of neuro-rehabilitation after injury is to access the residual capacity of the nervous system to improve function. We describe a patient who developed a quadrantopsia and drug-resistant focal epilepsy after an arteriovenous malformation hemorrhage. Thirty years later, he underwent placement of subdural electrodes for seizure mapping. Phosphenes were elicited in the blind right visual field with stimulation of occipital cortex. This case demonstrates that visual cortex may retain functional organization after a partial subcortical visual pathway injury. This persistent conscious mapping suggests that disconnected visual cortex could serve as a region for interfacing with neural prosthetic devices for acquired blindness.