Cerebral Vasospasm in Cortical Blindness Associated with Preeclamsia/Eclampsia Syndrome

Abstract

Background: Preeclampsia/eclampsia syndrome (Pe/ES) is a frequent complication during pregnancy. Neurologic or visual disturbances associated with Pe/ES are acute and severe. The women with cerebrovascular syndromes (CVS) are at increased risk of cerebrovascular complications that may lead to permanent sequelae and death. Case Reports: We describe the clinical course of three obstetric patients with Pe/ES complicated by CVS and cortical blindness. Posterior reversible encephalopathy syndrome (PRES) was seen in the three patients. One patient had the coexistence of PRES and reversible cerebral vasoconstriction syndrome. Transcranial Doppler (TCD) confirmed cerebral vasospasm in two patients. Follow-up with TCD allowed sequential assessments of the evolution of cerebral vasospasm. Conclusion: The variability of cerebral hemodynamics in Pe/ES could be the cause of diverse clinical and radiological expressions of these CVS. Cortical blindness is a manifestation of CVS associated to Pe/ES. PREScortical blindness associated with preeclampsia without seizures is an entity with severe neurologic dysfunction.