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Case Report

Cortical Blindness in a Postpartum Woman due to Posterior Reversible Encephalopathy Syndrome without Hypertension and with Uncommon Features

K. Gunasekaran, Assistant Professor, Department of Neurology, GovernmentMohan Kumaramangalam Medical College Hospital, Salem, Tamil Nadu, 636001, India , K. Gunasekaran1 , S. Eswari2 , S. Sivakumar3 , K. Thiruvarutchelvan4

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Indian Journal of Obstetrics and Gynecology 6(5):p 549-555, Sep-Oct 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6518.19

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Abstract

Cortical blindness is loss of vision with intact pupillary reflexes and normal optic fundus, due to damage to primary visual cortex. Cortical blindness in postpartum period is an uncommon event. Possible etiologies are cerebrovascular disease complicating pregnancy, eclampsia, clinical syndrome like posterior reversible encephalopathy syndrome (PRES), etc. Common among these is PRES. The common visual disturbances seen in patientswith posterior reversible  encephalopathy syndrome (PRES ) are blurred vision, visual field deficits like quadrantanopia and hemianopia, visual hallucinations and rarely PRES produces complete loss of vision. Here we report a postpartum woman who developed complete loss of vision due to PRES. Interestingly her blood pressure was normal, though PRES is commonly associated with elevated BP. In addition to that she demonstrated uncommon site of edema in neuroimaging. To add on, her MRI brain showed high signal in DWI image which usually occurs with ischemic infarct. She was managed conservatively with excellent recovery of her vision.

Keywords: Posterior Reversible Encephalopathy Syndrome; Cortical Blindness; Post-Partum

 

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DOI: DOI: http://dx.doi.org/10.21088/ijog.2321.1636.6518.19

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