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

TL;DR

A rare case of temporary vision loss and seizures after a C-section is linked to a reversible brain condition called PRES, which was successfully treated.

Contribution

This case report highlights PRES as a rare but important cause of transient vision loss and seizures after spinal anesthesia for C-section.

Findings

A 35-year-old patient developed headache, vision loss, and seizures after spinal anesthesia for C-section.

MRI findings were consistent with PRES, and symptoms resolved completely with supportive treatment.

Prompt diagnosis and management of PRES are crucial to prevent neurological complications.

Abstract

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.

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