RT Journal
A1 Soltes L, Schmalfuss IM, Bhatti M
T1 COrtical blindness due to reversible posterior leukoencephalopathysyndrome in a patient with thrombotic thrombocytopenic purpura and preeclampsia
JF Archives of Ophthalmology
JO Archives of Ophthalmology
YR 2004
FD December 1
VO 122
IS 12
SP 1885
OP 1887
DO 10.1001/archopht.122.12.1885
UL http://dx.doi.org/10.1001/archopht.122.12.1885
AB 
Neurological involvement in thrombotic thrombocytopenic purpura (TTP)is frequent. In one series, magnetic resonance imaging revealed brain lesionsin 88% of the patients with TTP.1 The 2 mostcommon cerebral lesions associated with TTP are edema and infarction.1- 2 Cerebral edema predominantly affectsthe white matter, but when it affects gray matter in the territory of theposterior cerebral circulation, it may resemble the radiological findingsof reversible posterior leukoencephalopathy syndrome (RPLS). We report a caseof reversible cortical blindness caused by RPLS in a patient with TTP exacerbationand preeclampsia. To our knowledge, there have been only 10 previously reportedcases of RPLS in the setting of TTP.1- 2 Wealso discuss the role of diffusion-weighted imaging (DWI) in differentiatingreversible from irreversible ischemic lesions.