Anesth Pain Med.  2017 Apr;12(2):111-116. 10.17085/apm.2017.12.2.111.

Transient visual loss after lung surgery in a healthy patient: posterior reversible encephalopathy syndrome: A case report

• Kang TH
• Na SJ
• Sung TY
• Cho CK
• Kwon HU
• Kang PS

• KMID: 2379729
• DOI: http://doi.org/10.17085/apm.2017.12.2.111

Abstract

Postoperative visual loss is a rare complication of general anesthesia in patients undergoing lung surgery. If the visual complication is permanent, it can greatly affect the patient's quality of life. Posterior reversible encephalopathy syndrome (PRES) leads to visual disturbances and may be associated with hypertension, renal disease, eclampsia, and chemotherapy. Although PRES is usually reversible, delayed diagnosis and treatment can result in permanent damage. We herein report a case of PRES in a patient with no medical history. The patient's symptoms included somnolence, visual loss, and headache. He was treated with conservative therapy, and his vision abruptly recovered three days after surgery. He was discharged from the hospital without neurologic complications 13 days after surgery.

Keyword

Blindness; Posterior leukoencephalopathy syndrome

MeSH Terms

Anesthesia, General
Blindness
Delayed Diagnosis
Drug Therapy
Eclampsia
Female
Headache
Humans
Hypertension, Renal
Lung*
Posterior Leukoencephalopathy Syndrome*
Pregnancy
Quality of Life

Figure

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  Fig. 1 Diffusion-weighted axial magnetic resonance images. (A) Initial imaging was taken on the day vision was lost and showed a hyperintense signal in the right temporo-occipital area. (B) After 13 days, the hyperintensity of the initial lesions had almost completely resolved.

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  Fig. 2 Fundoscopic findings on the day after onset of visual loss. Both images show a normal ocular fundus.

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  Fig. 3 Magnetic resonance images at 3 days after onset of visual loss. Both (A) axial fluid-attenuated inversion recovery and (B) apparent diffusion coefficient show a high-intensity lesion (arrows) indicative of vasogenic cerebral edema.

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