Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome
Authors: Mamta Bhat, Santanu Acharya
Background: Posterior reversible encephalopathy syndrome (PRES) is an unusual clinical entity seen associated with blood pressure (BP) fluctuations presenting with acute neurological symptoms. This is an unusual case of PRES due to severe preeclampsia, with clinical presentation of cortical blindness and hypertension, with absence of headache or seizures. Case Presentation: A primigravida, with no significant medical history, presented with significant proteinuria and worsening generalized itching and normotensive at 37 weeks 6 days of gestation. Due to elevated urate and raised urine protein induction of labor was planned. Ten minutes after vaginal delivery, patient reported sudden loss of vision with only being able to perceive light. She developed hypertension, hyperreflexia, and clonus. Aggressive management for severe pre-eclampsia was initiated. Her vision started improving as soon as her BP started normalizing. Imaging revealed the possibility of PRES with a superimposed focus of acute ischemia. She was discharged on antihypertensives and followed up by renal physicians. Within 2 months she recovered very well. Conclusion: This is an unusual case of PRES due to severe pre-eclampsia, with clinical presentation of only cortical blindness with absence of headache or seizures. Prompt recognition and aggressive management of severe pre-eclampsia resulted in resolution of symptoms.
Keywords: Posterior reversible encephalopathy syndrome, pre-eclampsia, cortical blindness, hypertension, headache, pregnancy
Authors
Correspondence to:
Mamta Bhat, Ayrshire Maternity Unit, University Hospital Crosshouse, Kilmarnock, Scotland mamtabhat78@gmail.com
Publication history:
Received 07 Aug 2020
Revised 02 Oct 2021
Accepted 07 Oct 2021
Published online 09 Nov 2021
Published in print 17 Nov 2021
Bhat M, Acharya S. Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome. EJMCR. 2021; 5(10): 283-286. doi:
10.24911/ejmcr/173-1596824862
Bhat M, Acharya S. Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome. https://www.ejmcr.com/?mno=122577 [Access: April 23, 2024]. doi:
10.24911/ejmcr/173-1596824862
Bhat M, Acharya S. Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome. EJMCR. 2021; 5(10): 283-286. doi:
10.24911/ejmcr/173-1596824862
Bhat M, Acharya S. Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome. EJMCR. (2021), [cited April 23, 2024]; 5(10): 283-286. doi:
10.24911/ejmcr/173-1596824862
Bhat, M. & Acharya, . S. (2021) Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome. EJMCR, 5 (10), 283-286. doi:
10.24911/ejmcr/173-1596824862
Bhat, Mamta, and Santanu Acharya. 2021. Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome. European Journal of Medical Case Reports, 5 (10), 283-286. doi:
10.24911/ejmcr/173-1596824862
Bhat, Mamta, and Santanu Acharya. "Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome." European Journal of Medical Case Reports 5 (2021), 283-286. doi:
10.24911/ejmcr/173-1596824862
Bhat, Mamta, and Santanu Acharya. "Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome." European Journal of Medical Case Reports 5.10 (2021), 283-286. Print. doi:
10.24911/ejmcr/173-1596824862
Bhat, M. & Acharya, . S. (2021) Transient cortical blindness at delivery-an unusual case report on posterior reversible encephalopathy syndrome. European Journal of Medical Case Reports, 5 (10), 283-286. doi:
10.24911/ejmcr/173-1596824862