Cortical blindness in severe preeclampsia: Computed tomography, magnetic resonance imaging, and single-photon-emission computed tomography findings

Background: Cortical blindness is a complication of severe preeclampsia, bu t it is unclear whether it results from cerebral vasospasm and ischemic inj ury or vasogenic (hydrostatic) edema due to increased capillary permeabilit y. Case: Reversible cortical blindness in a 33-year-old gravida 2, para 1, wit h severe postpartum preeclampsia after evacuation of a partial molar pregna ncy at 19 weeks' gestation is presented. Initial neuroimaging studies showe d hyperperfusion on head single-photon-emission computed tomography scan, w hich corresponded with lesions found on head computed tomography and magnet ic resonance imaging scans. Follow-up neuroimaging studies 2 weeks later, b y which time the patient's visual acuity had returned to normal, showed com plete resolution of radiologic abnormalities. Conclusion: Neuroimaging studies in a woman with severe postpartum preeclam psia complicated by reversible cortical blindness showed that blindness res ulted from vasogenic (hydrostatic) cerebral edema and not cerebral vasospas m. (Obstet Gynecol 2000;95:1017-9. (C) 2000 by The American College of Obst etricians and Gynecologists.).