A case of transient cortical blindness following coronary intervention

Abstract Transient cortical blindness is rare in the setting of cardiac catheterization and percutaneous coronary intervention. The initial clinical manifestations present similarly to acute posterior cerebral hemorrhage and causes great alarm in both patients and interventional cardiologists. A challenging clinical situation arises, as interruption of antiplatelet therapy due to concerns of hemorrhagic exacerbation poses a risk in the setting of recently placed drug eluting coronary stent. We present a case of an 83-year-old male who developed acute transient bilateral loss of visual acuity following PCI. On non-contrast head CT, he had bilateral hyper densities in the occipital lobes concerning for hemorrhage. Antiplatelet therapy was transiently held until two repeat head CT confirmed resolution of initial hyper densities in setting of no neurological deficits. His vision loss and imaging abnormalities resolved in less than 12 hours and presentation was consistent with contrast-induced transient cortical blindness.