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March 21, 1980

Cortical Blindness in Puerperium

Author Affiliations

Metropolitan Hospital Center New York

JAMA. 1980;243(11):1134. doi:10.1001/jama.1980.03300370014014

To the Editor.—  Cortical blindness is most frequently caused by occlusive vascular disease involving both occipital lobes. Two patients had cortical blindness during the puerperium.

Report of Cases.—Case 1.—  A 34-year-old primigravida had headache, vomiting, and loss of vision on the fourth day following cesarean section. The pupils were equal and reacted to light; fundi were normal, but optokinetic nystagmus was absent. On the sixth day, blindness persisted, and she had a focal motor and a generalized seizure. Her blood pressure was 210/120 mm Hg, and urine showed 3+ proteinuria.The next day, she could read but experienced well-formed visual hallucinations. Optokinetic nystagmus was present. An EEG showed absence of alpha activity and bilateral bursts of high-amplitude, 2- to 3-Hz activity. On the eighth day, mild, right hemiparesis was noted. A radionuclide brain scan was normal. An EEG showed alpha activity and 4- to 6-Hz bilateral slowing. An