Korean J Anesthesiol.  2004 Jul;47(1):122-125. 10.4097/kjae.2004.47.1.122.

Bilateral Cortical Blindness Due to Parieto-Occipital Infarction after General Anesthesia: A case report

• Ahn KR
• Choi JK
• Kim CS
• Kang KS
• Kim JE
• Yoo SH
• Kwon JH

• KMID: 2237571
• DOI: http://doi.org/10.4097/kjae.2004.47.1.122

Abstract

Cortical blindness is characterized by visual sensation loss with retention of pupillary reaction to light, and a normal fundoscopic examination. The suggested causes are emboli, profound hypotension, anemia, and infarction of watershed areas in the parietal or occipital lobe. We experienced a case of cortical blindness with severely reduced visual acuity after penile cancer surgery under general anesthesia. In the acute stage, visual acuity was slightly improved, but over the course of several months, no further improvement in visual acuity occurred. In this case there was no severe hypotension or anemia during the operation. Two days after the operation, electroencephalography (EEG) was performed during the period of blindness and the recording obtained was abnormal, with no alpha rhythm. Biparieto-occipital lucency was found by magnetic resonance imaging (MRI). Therefore parieto-occipital infarction due to seizure, embolus, or thrombosis could be considered a possible etiology. We concluded that cortical blindness can unexpectedly develop perioperatively and postoperatively, and that close monitoring of the patient and adequate management are essential.

Keyword

cortical blindness; EEG; embolus; MRI; parieto-occipital infarction; seizure

MeSH Terms

Alpha Rhythm
Anemia
Anesthesia, General*
Blindness
Blindness, Cortical*
Electroencephalography
Embolism
Humans
Hypotension
Infarction*
Magnetic Resonance Imaging
Male
Occipital Lobe
Penile Neoplasms
Rabeprazole
Seizures
Sensation
Thrombosis
Visual Acuity