Watanabe K, Kii N, Hatakenaka S, Yoshimura Y, Nakago K, Mochizuki T, Inoue H, Arai T, Takeuchi K
Department of Anesthesiology, Ehime Prefectural Imabari Hospital.
Masui. 1997 Aug;46(8):1122-6.
We report a case of 31-year-old woman with pregnant toxicosis, who developed transient blindness after caesarean section under lumbar anesthesia. The patient was hypoxic due to atelectasis when she developed blindness, but she had no ophthalmologic abnormalities. MRI depicted abnormal high intensity areas (HIA) with T 2-weighted images (T 2 WI) in the occipital lobes and the basal ganglia. CT could not detect any of these MRI findings. The patient regained her vision four days after the onset. The HIA disappeared in a follow up MRI (T 2 WI) two weeks after the onset. The patient was diagnosed as cortical blindness due to RIND. Although most of the transient cortical blindness are accompanied with pregnant toxicosis with hypertension, there are some cases without pregnant toxicosis. We stress the importance of maintaining the blood pressure within the normal range in patients with hypertension who undergo surgery under spinal anesthesia.
我们报告一例31岁患有妊娠中毒症的女性患者，她在腰麻下行剖宫产术后出现短暂失明。患者失明时因肺不张而缺氧，但眼部无异常。MRI在枕叶和基底节区的T2加权像（T2WI）上显示出异常高信号区（HIA）。CT未检测到这些MRI表现。患者在发病四天后视力恢复。发病两周后的随访MRI（T2WI）显示HIA消失。该患者被诊断为可逆性缺血性神经功能障碍导致的皮质盲。虽然大多数短暂性皮质盲伴有妊娠中毒症合并高血压，但也有一些病例无妊娠中毒症。我们强调在脊髓麻醉下接受手术的高血压患者将血压维持在正常范围内的重要性。
