Teaching NeuroImages Neurology Resident and Fellow Section © 2014 American Academy of Neurology 46 year-old women with acute headache, post seizure confusion.

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Teaching NeuroImages Neurology 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

Imaging AB 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 H 2 0. 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