Transient blindness associated with reversible occipital white matter abnormalities: two patients studied by MR, CT,...

Reversible, multifocal hyperintense T2 signal abnormalities were noted within the occipital and posterior parietal subcortical white matter in a previously healthy 59-year-old right-handed woman with acute onset of cortical blindness and seizures. Repeat brain magnetic resonance imaging and a positron emission tomographic scan of 18F-fluorodeoxyglucose brain uptake performed 2 months after the ictal event failed to reveal any abnormality. This patient is similar to a 57-year-old female who developed severe headache and magnetic resonance signal abnormalities in the subcortical white matter of both occipital lobes, which later normalized, as judged by correlative, sequential computed tomographic examinations. This study emphasizes that an increasingly more frequent phenomenon of reversible MRI signal abnormalities can occur within the occipital subcortical white matter in acutely ill individuals, and not be associated with any lasting abnormalities on clinical examination or on radiological imaging studies such as computed tomography, magnetic resonance imaging, or positron emission tomography.