Annals of Indian Academy of Neurology
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CASE REPORT
Year : 2011  |  Volume : 14  |  Issue : 4  |  Page : 298-300

Cortical blindness after contrast-enhanced CT scan in a patient of sarcoidosis - Is it related to posterior reversible encephalopathy syndrome?


1 Department of Neurology, Indraprastha Apollo Hospital, New Delhi, India
2 Department of Neurology, Guru Teg Bahadur Hospital, New Delhi, India

Correspondence Address:
Vinit Suri
Department of Neurology, Indraprastha Apollo Hospital, Sarita Vihar, New Delhi - 110 076
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-2327.91956

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Transient cortical blindness (TCB) is a well known but rare complication of administration of contrast agent. In this case report, we present a 53-year-old woman who is a follow-up case of sarcoidosis and developed TCB with focal neurological symptoms following contrast-enhanced computed tomography scan. Magnetic resonance imaging revealed bilateral T2/Flair hyperintensities in parieto-occipital, high frontal, and cerebellar hemispheres with involvement of corpus callosum. Clinically and radiologically patient improved significantly in 4 days. The exact mechanism is still speculative and its possible relationship with posterior reversible encephalopathy syndrome is briefly discussed. The patient's symptoms were presumed to be exacerbated by presence of hypertension, underlying autoimmune disorder, sepsis, and high osmolality of contrast agent. Though there is no definite evidence to suggest that a certain treatment regimen improves the natural history of this disease but control of risk factors can possibly prevent this rare but devastating complication.


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