Bálint Syndrome From Posterior Cerebral Artery Infarctions Case Report

Bálint syndrome is a debilitating, rare neurological condition characterized by a triad of visuospatial distortions: simultanagnosia, optic ataxia, and oculomotor apraxia. We highlight the pathways involved with infarction of the posterior cerebral artery (PCA), which may be an important underlying factor leading to the development of clinical presentations found in Bálint syndrome.

We present a case of a middle-aged patient who presents with Bálint syndrome following a PCA infarction.

A 49-year-old male bus driver with a recent PCA infarction presented with all 3 components of Bálint syndrome. His clinical course was notable for simultanagnosia, optic ataxia, oculomotor apraxia, and a right greater than left lower visual field deficit. Neuroimaging revealed infarctions in the P1 and bilateral P2 segments of the posterior cerebral arteries, affecting the parieto-occipital regions known to underlie visuospatial processing. Laboratory workup helped exclude opportunistic and systemic causes, supporting a stroke-related etiology.

Posterior cerebral artery infarctions may be responsible for the clinical presentation of Bálint syndrome; however, further investigation into vascular and neuronal networks underlying the clinical signs and symptoms of Bálint syndrome is needed.