MR findings of cortical blindness following cerebral angiography: is this entity related to posterior reversible leukoencephalopathy?

Abstract

We describe MR findings in three patients who experienced transient cortical blindness following cerebral angiograms. All angiograms were performed by using the same nonionic contrast medium. On the basis of similar clinical and radiologic findings, we believe that this entity is closely related to and probably has the same pathophysiology as posterior reversible leukoencephalopathy.

Fig 1.

FLAIR MR images show hyperintensities (arrows) in occipital cortices bilaterally (A, B). Coil treatment of the right superior cerebellar artery aneurysm (long arrow) can be seen. No restricted diffusion noted on the diffusion images (C, D). Parameters: TR, 6000; TE, 128; FOV, 24; TI, 2000; FA, 90°; matrix, 192 × 256; bandwidth, 12.5.

Fig 2.

Axial noncontrast CT scan reveals a relatively large gyriform hyperattenuation (short arrows) in the left parietooccipital cortex (A, B). No mass effect is seen. FLAIR MR images show subtle hyperintensity (C, D) in the left occipital cortex (long arrow). Parameters: TR, 3056; TE, 112; FOV, 24; FA, 90°; matrix, 192 × 256; bandwidth, 15.6.

Fig 3.

FLAIR (A, B) and T2-weighted (C, D) MR images show gyriform hyperintensities in both occipital cortices (arrows), larger on the right than on the left. No mass effect is noted. Diffusion imaging (E, F) does not show any restricted fluid motion. Parameters for FLAIR match those used for Figure 1. Parameters for diffusion imaging: TR, 6000; TE, 103.1; FOV, 24; matrix, 100 × 100.