Metamorphopisa of different types have been noted in patients with posterior cerebral artery infarction, especially when the lesion is bilateral or occipitotemporal. Micropsia (objects appearing reduced in size) is commonly due to-retinal
disease,
which
causes displacement of the receptor cells. It can be hysterical in origin, but rarely micropsia is accompanied by occipitotemporal lesion. We present here a case of micropsia due to bilateral occipital infarction after coronary angiography (CAG).
A 55 year-old male had experienced cortical blindness due to cerebral infarction following CAG. Brain CT reveals poorly defined low density lesions in biiateral occipital cortices. Brain SPECT shows perfusion defect in both occipital lobes with
markedly
decreased perfusion in left temporal area. Two weeks later, as he regains visual acuity, he complains of micropsia, i. e., his hands hands and fingers look small and the people outside the window looks very small like ants. This perverted visual
illusion lasts about 15 days.
|