Cortical blindness, a rare complication of pre-eclampsia

Area of Science:

• Obstetrics and Gynecology
• Neurology
• Emergency Medicine

Background:

• Cortical blindness is a rare but serious complication during pregnancy.
• Pre-eclampsia with HELLP syndrome can present with neurological symptoms.
• Undiagnosed conditions in pregnant adolescents pose significant risks.

Purpose of the Study:

• To report a case of a pregnant teenager with undiagnosed pre-eclampsia and HELLP syndrome presenting with cortical blindness.
• To illustrate the diagnostic challenges and management of severe pre-eclampsia in an adolescent.
• To highlight the rapid visual recovery following delivery.

Main Methods:

• Case report of a pregnant teenager presenting to the emergency department.
• Clinical evaluation including assessment for pre-eclampsia and HELLP syndrome.
• Diagnostic imaging including CT and MRI of the brain.
• Management involved immediate cesarean section.

Main Results:

• The patient presented with sudden onset cortical blindness.
• Diagnosis of pre-eclampsia with HELLP syndrome was established.
• A viable 32-week infant was delivered via cesarean section.
• Brain imaging showed occipital lobe abnormalities and possible subarachnoid hemorrhage.
• Vision improved immediately postpartum and normalized within days.

Conclusions:

• Cortical blindness in pregnancy can be a manifestation of severe pre-eclampsia with HELLP syndrome.
• Prompt diagnosis and delivery are crucial for maternal and fetal outcomes.
• Neurological deficits associated with pre-eclampsia may be reversible after delivery.