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MR imaging of postpartum cortical blindness
W F Coughlin1, S K McMurdo, T Reeves
1Department of Radiology, Tripler Army Medical Center, Honolulu, HI 96859-5000.
Journal of Computer Assisted Tomography
|July 1, 1989
Summary
Cortical blindness, a rare toxemia of pregnancy symptom, was studied in two postpartum women. While CT and MR showed reversible swelling, follow-up MR revealed permanent brain damage invisible to CT.
Area of Science:
- Neurology
- Radiology
- Obstetrics
Background:
- Toxemia of pregnancy, also known as pre-eclampsia or eclampsia, can present with unusual neurological complications.
- Cortical blindness is a rare but recognized manifestation of severe hypertensive disorders during pregnancy.
Observation:
- Two cases of postpartum blindness following toxemia of pregnancy are presented.
- Neuroimaging, including computed tomography (CT) and magnetic resonance (MR) imaging, was performed.
Findings:
- Both CT and MR imaging demonstrated reversible occipital lobe edema.
- Follow-up MR imaging revealed evidence of hemorrhagic and nonhemorrhagic infarction in the occipital lobes.
- These infarcts were not apparent on the corresponding CT scans, highlighting a limitation of CT in detecting subtle ischemic changes.
Implications:
- This case series underscores the importance of advanced neuroimaging, particularly MR, in evaluating visual disturbances in postpartum women with a history of toxemia.
- It suggests that MR imaging is more sensitive than CT in detecting ischemic brain injury, even when CT findings appear normal.
- Early and accurate diagnosis of occipital lobe injury is crucial for appropriate patient management and prognosis in cases of postpartum visual impairment.