Postpartum cortical blindness is a rare complication. It may be due to the hypercoagulable state associated with pregnancy, eclampsia, and severe blood loss due to either intra or postpartum hemorrhage. A 42-year-old woman underwent a hysterectomy for disseminated intravascular coagulation (DIC) and massive hemorrhage in amniotic fluid during labor. Blindness occurred 8 hours after surgery. Fundus examination was normal. Magnetic resonance imaging (MRI) showed abnormal signals in bilateral ventricles and mild edema of the pituitary gland. After treatment with vitamin B1, mecobalamin, and methylprednisolone, light perception was restored on day 2, and visual acuity returned to normal on day 5. After 2 years of follow-up evaluation, both the patient and the newborn were normal.
References
[1]
Williams, E.L. (2002) Postoperative Blindness. Anesthesiology Clinics of North America, 20, 605-622, viii. https://doi.org/10.1016/S0889-8537(02)00007-X
[2]
Corso, C.M., Tanaka, P.P., Khon, K., Corso, C.M., Tanaka, P.P. and Khon, K. (2006) Optic Nerve Ischemia after Spine Surgery: Case Report. Revista Brasileira De Anestesiologia, 56, 273-277. https://doi.org/10.1590/S0034-70942006000300007
[3]
Fernandes, S.I.L., Carvalho, R.J.R., Santos, L.M.G., Sá, F.M.P.M., Antunes, J.A.S., Mendes, A.S.L., et al. (2019) Transient Cortical Blindness Following Coronary Angiography. JACC: Case Reports, 1, 188-191.
https://doi.org/10.1016/j.jaccas.2019.06.014
[4]
Rama, B.N., Pagano, T.V., DelCore, M., Knobel, K.R. and Lee, J. (1993) Cortical Blindness after Cardiac Catheterization: Effect of Rechallenge with Dye. Catheterization and Cardiovascular Diagnosis, 28, 149-151.
https://doi.org/10.1002/ccd.1810280211
[5]
Kesler, A., Kaneti, H. and Kidron, D. (1998) Transient Cortical Blindness in Preeclampsia with Indication of Generalised Vascular Endothelial Damage. The Journal of Neuro-Ophthalmology, 18, 163-165.
https://doi.org/10.1097/00041327-199809000-00001
[6]
Argenta, P.A. and Morgan, M.A. (1998) Cortical Blindness and Antonsyndrome in a Patient with Obstetric Hemorrhage. Obstetrics & Gynecology, 91, 810-812.
https://doi.org/10.1097/00006250-199805001-00007
[7]
Käsmann, B. and Ruprecht, K.W. (1995) Ecclamptogenic Gerstmann’s Syndrome in Combination with Cortical Agnosia and Cortical Diplopia. German Journal of Ophthalmology, 4, 234-238.
[8]
Nawaz, N., Buksh, A. R. (2018) Amniotic Fluid Embolism. Journal of the College of Physicians and Surgeons Pakistan: JCPSP, 28, S107-S109.
https://doi.org/10.29271/jcpsp.2018.06.S107
[9]
Fitzpatrick, K.E., Tuffnell, D., Kurinczuk, J.J. and Knight, M. (2016) Incidence, Risk Factors, Management and Outcomes of Amniotic-Fluid Embolism: A Population-Based Cohort and Nested Case-Control Study. BJOG: International Journal of Gynecology & Obstetrics, 123, 100-109. https://doi.org/10.1111/1471-0528.13300