Posterior reversible encephalopathy syndrome in 46 of 47 patients with eclampsia

Justin Brewer, Michelle Y. Owens, Kedra Wallace, Amanda A. Reeves, Rachael Morris, Majid Khan, Babbette Lamarca, James N. Martin

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: We sought to investigate the concurrence of posterior reversible encephalopathy syndrome (PRES) with eclampsia and to describe the obstetric, radiological, and critical care correlates. Study Design: This was a single-center, 2001-2010 retrospective cohort study of all patients with eclampsia who underwent neuroimaging via magnetic resonance imaging (MRI) or computerized tomography (CT) with or without contrast. Results: Forty-six of 47 of eclamptic patients (97.9%) revealed PRES on neuroimaging using 1 or more modalities: MRI without contrast, 41 (87.2%); MRI with contrast, 27 (57.4%); CT without contrast, 16 (34%); CT with contrast, 7 (14.8%); and/or magnetic resonance angiography/magnetic resonance venography, 2 (4.3%). PRES was identified within the parietal, occipital, frontal, temporal, and basal ganglia/brainstem/cerebellum areas of the brain. Eclampsia occurred antepartum in 23 patients and postpartum in 24 patients. Headache was the most common presenting symptom (87.2%) followed by altered mental status (51.1%), visual disturbances (34%), and nausea/vomiting (19.1%). Severe systolic hypertension was present in 22 patients (47%). Conclusion: The common finding of PRES in patients with eclampsia suggests that PRES is a core component of the pathogenesis of eclampsia. Therapy targeted at prevention or reversal of PRES pathogenesis may prevent or facilitate recovery from eclampsia.

Original languageEnglish (US)
Pages (from-to)468.e1-468.e6
JournalAmerican journal of obstetrics and gynecology
Volume208
Issue number6
DOIs
StatePublished - Jun 2013
Externally publishedYes

Keywords

  • cerebral imaging
  • eclampsia
  • posterior reversible encephalopathy syndrome

ASJC Scopus subject areas

  • Obstetrics and Gynecology

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