Bilateral mesial occipital lobe infarction after cardiogenic hypotension induced by electrical shock.

A 28-year-old man developed cerebral blindness from infarction of both mesial occipital lobes after cardiogenic hypotension induced by electrical shock. He remained globally encephalopathic for several weeks, but his most enduring deficit was bilateral homonymous hemianopias with macular sparing. Cerebral visual loss after electrical injury has been sparsely reported. It has been attributed to direct thermal injury of the skull or posterior dural venous sinuses. We suggest that cerebral blindness after cardiogenic hypotension in which there is no thermal injury to the scalp be attributed to hypotensive infarction of the mesial occipital lobes, which lie in the terminal domain of the posterior cerebral arteries.