Occipital Hypoperfusion and Reversible Blindness after Lumbar Epidural Steroid Injection

Abstract

Background— There are anecdotal reports of blindness following epidural steroid injection attributed to retinal
hemorrhages. We report a case with bilateral occipital hypoperfusion and blindness following epidural steroid
injection.
Case Description— A 82-year-old woman developed acute onset bilateral vision loss in few hours after she un
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derwent lumbar epidural steroid injections. A computed tomographic (CT) perfusion scan and angiography of brain
demonstrated hypoperfusion of both occipital lobes without any arterial occlusion. Patient’s vision returned to nor
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mal within 4th day of hospital admission. A repeat CT perfusion 4 days later demonstrated resolution of perfusion
abnormalities.
Conclusions— Our case demonstrates that vision loss after epidural steroid injection may be related to occipital
hypoperfusion.