Unusual Presentation of Reversible Transient Vision Loss After Caesarean Section Under Subarachnoid Block: A Case Report

• Published in: Curēus (Palo Alto, CA) Vol. 16; no. 1; p. e52522
• Main Authors: Chatterjee, Abhishek, Mahanty, Pratap Rudra, Nag, Deb Sanjay, Sarkar, Nilanjan
• Format: Journal Article
• Language: English
• Published: United States Cureus Inc 18.01.2024
• Subjects: Blood pressure; Case reports; Cytotoxicity; Edema; Headaches; Hypertension; Magnetic resonance imaging; Patients; Postpartum period; Pregnancy; loss of vision; posterior reversible encephalopathy syndrome; pres; caesarean section; pregnancy
• ISSN: 2168-8184; 2168-8184
• DOI: 10.7759/cureus.52522

A transient vision loss is not commonly encountered during the postoperative period following a caesarean section. Although numerous causes have been suggested for transient vision loss, when loss of vision is associated with seizures and headaches, the differential diagnoses include hemolysis, elevated liver enzymes, low platelet syndrome, reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy syndrome (PRES), dural venous thrombosis, and central retinal arteriolar occlusion. We report a case of a 35-year-old patient who underwent an elective caesarean section under spinal anaesthesia and developed a headache followed by loss of vision and seizures during the postoperative period. An MRI scan of the brain on the same day revealed subtle hyperintensity in bilateral parieto-occipital lobes in the cortical and subcortical areas and bilateral cerebral hemispheres, which indicates PRES. Rapid and complete resolution of symptoms was observed with supportive treatment. Therefore, prompt suspicion and effective management of PRES are of paramount importance to prevent short- and long-term neurological deficits.