Kesler A, Kaneti H, Kidron D
Department of Neurology, Meir Medical Center, Kfar Saba, Israel.
J Neuroophthalmol. 1998 Sep;18(3):163-5.
A 26-year-old woman with twin fetuses of 28 weeks' gestational age had symptoms of preeclampsia and was admitted to the hospital for observation. Nine days later, after reporting a severe headache, the patient experienced loss of vision in both eyes. An emergency computed tomographic brain scan was performed to rule out intracranial hemorrhage, and cesarean delivery was performed. Twelve hours after the operation, the patient's vision improved gradually and returned to normal after 24 hours. The placenta was submitted to pathologic examination, and magnetic resonance imaging was performed 4 days after birth. Recent thrombosis observed in the histologic section of the placenta, ischemic changes in the brain seen in the computed tomographic and magnetic resonance scans, and severe proteinuria manifested clinically suggest vascular endothelial damage as the underlying mechanism in this case of preeclampsia-related transient cortical blindness.
一名怀有28周双胎胎儿的26岁女性出现子痫前期症状，入院观察。九天后，在报告严重头痛后，患者双眼视力丧失。进行了紧急脑部计算机断层扫描以排除颅内出血，并实施了剖宫产。术后12小时，患者视力逐渐改善，24小时后恢复正常。胎盘进行了病理检查，并在出生后4天进行了磁共振成像。胎盘组织学切片中观察到近期血栓形成，计算机断层扫描和磁共振扫描中可见脑部缺血性改变，临床上出现的严重蛋白尿表明血管内皮损伤是该例子痫前期相关短暂性皮质盲的潜在机制。
