The patient is a 50 years old woman, known case of major depression, brought to
emergency ward of Tabriz Imam Reza hospital with chief complaint of blindness.
Half an hour before coming to ED, she said that she canâ€™t see anything suddenly. The
patient triaged to acute ward. Vital signs at the first visit: Blood pressure was 220/100,
respiratory rate was 20, pulse rate 89 beat per minute, her temperature was 37.1 Axillary,
and she was oriented. Hear visual acuity was in hand motion in both eyes, Physical exam
was normal, a cranial CT scan without contrast material showed bilateral low-density
areas involving the white matter of the parieto-occipital lobe with extension into the gray
matter of the right posterior parietal lobe.
In Cranial T2-weighted MRI showed increased signal intensity in the occipital lobes
bilaterally, centered at the gray matterâ€“white matter junction. T1-weighted images
showed hypointensities in these areas. Attention to brain CT and MRI finding when we
put this finding beside the history and physical exam, the nearest and best diagnosis is
Reversible Posterior Leukoencephalopathy Syndrome. As this case report is
about Posterior Leukoencephalopathy a more convincing statement surrounding the
certainty of the diagnosis is needed.
Key words: hypertensive encephalopathy, blindness, leukoencephalopathy
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