Transient cortical blindness in pre-eclampsia due to cerebral vasospasm

The pathogenesis of cortical blindness as a rare complication in severe pre eclampsia is still unclear. The case of a women with postpartum blindness i s reported in which CT and MRI initially showed cortical and subcortical ed ema in the parieto-occipital lobes. At this time cerebral angiography and t ranscranial color-coded sonography (TCCS) revealed widespread cerebral vaso spasm. Mean blood flow velocities in the middle and posterior cerebral arte ry and carotid syphon initially reached 380 cm/s and normalized within 2 we eks. While the patient's vision improved rapidly, follow-up MRI disclosed i schemic lesions and petechial hemorrhage in the occipital cortex. This case provides rare documentation that transient blindness in patients with pree clampsia may result from parieto-occipital ischemia due to cerebral vasospa sm. In such patients TCCS may be useful to detect vasospasm associated with preeclampsia/eclampsia.