Postpartum Cortical Blindness

Abstract

A 19-year-old woman, status post an uneventful pregnancy and delivery, developed a severe migranous headache and visual loss at 2 hours post partum. Computed tomography demonstrated ischemia and edema in the bilateral parietooccipital cortices. Magnetic resonance imaging (MRI) ruled out cerebral sinus thrombosis. Magnetic resonance imaging angiography (MRA) did not reveal remarkable abnormal findings in the major arteries. Cerebral angiography revealed circulation disorder of the bilateral posterior cerebral arteries in the capillary phase. The patient recovered with conservative therapy. The ischemic lesion associated with eclampsia often affects the parieooccipital cortices and basal ganglia. In such cases, the ischemic lesions are often reversible, and the symptoms resolve quickly, usually within a week. Conservative therapy is warranted when major artery stenosis or venous thrombosis can be excluded. Careful follow-up is essetial, however, as cases in which the vasospasm worsened and the patient died have been reported.