Teaching NeuroImagesNeurology

Resident and Fellow Section

© 2014 American Academy of Neurology

46 year-old women with acute headache, post seizure confusion and

visual loss.

VIGNETTE

• No past medical history• Urgent CT performed (Figure e-1). • MRI confirmed the suspected diagnosis and

unusual findings (Figure e-2).

C. Champeaux, et al.© 2014 American Academy of Neurology

Imaging

C. Champeaux, et al.© 2014 American Academy of Neurology

ImagingA B C

C. Champeaux, et al.© 2014 American Academy of Neurology

Cortical blindness following acute obstructive hydrocephalus by a colloid cyst• External ventricular drains inserted in emergency

demonstrated a cerebrospinal fluid under pressure, above 40 cm H20.

• CT angiogram didn’t show any thrombosis of the posterior cerebral arteries. Presumed ischemic mechanism was the acute compression of PCAs.

• After neurosurgical excision of the colloid cyst, she remained blind. Ophthalmology assessment confirmed the diagnosis of cortical blindness with macular sparing.

C. Champeaux, et al.© 2014 American Academy of Neurology