Posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient: case report
Abstract Background Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition which comprises various neurological symptoms. This syndrome could be complicated by intracranial hemorrhage including subarachnoid hemorrhage (SAH). However, SAH is rarely seen in eclamptic patients wi...
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| Format: | Article |
| Language: | English |
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BMC
2018-11-01
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| Series: | BMC Neurology |
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| Online Access: | http://link.springer.com/article/10.1186/s12883-018-1186-1 |
| _version_ | 1818293594745733120 |
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| author | Dan Hu Jing Xiong Yunfei Zha Zhaohui Zhang |
| author_facet | Dan Hu Jing Xiong Yunfei Zha Zhaohui Zhang |
| author_sort | Dan Hu |
| collection | DOAJ |
| description | Abstract Background Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition which comprises various neurological symptoms. This syndrome could be complicated by intracranial hemorrhage including subarachnoid hemorrhage (SAH). However, SAH is rarely seen in eclamptic patients with PRES. Case presentation A 34-weeks-pregnant woman at the age of 33 was admitted to the obstetrics department because of an episode of generalized tonic-clonic seizure. Before the seizure, the patient had a headache and was found to have an abnormal systolic blood pressure of 160 mmHg. On admission, systolic and diastolic blood pressures were up to 182 and 99 mmHg, respectively. Emergent cesarean section was then performed. On hospital day (HD) 2, cranial non-contrast computed tomography (CT) revealed the existence of SAH. Multiple areas of high signals on T2-weighted and fluid attenuated inversion recovery (FLAIR) sequences were shown by cranial magnetic resonance imaging (MRI) performed 2 days later. CT-angiography studies didn’t reveal intracranial aneurysm. After anti-hypertensive treatment, arterial blood pressure of the patient was gradually tapered to normal values. Eventually, the patient was discharged without any residual symptoms. Conclusions SAH is a rare complication of PRES in eclamptic patients. In patients with PRES, occurrence of SAH is related to increased morbidity and mortality especially when the hemorrhage is diffuse or massive. Our patient had a minor hemorrhage. The good prognosis might also be due to immediate elimination of the risk factor of PRES by emergent delivery. |
| first_indexed | 2024-12-13T03:18:20Z |
| format | Article |
| id | doaj.art-bd93b9454d894132bbf3f792b4b64dc9 |
| institution | Directory Open Access Journal |
| issn | 1471-2377 |
| language | English |
| last_indexed | 2024-12-13T03:18:20Z |
| publishDate | 2018-11-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Neurology |
| spelling | doaj.art-bd93b9454d894132bbf3f792b4b64dc92022-12-22T00:01:25ZengBMCBMC Neurology1471-23772018-11-011811510.1186/s12883-018-1186-1Posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient: case reportDan Hu0Jing Xiong1Yunfei Zha2Zhaohui Zhang3Department of Neurology, Renmin Hospital of Wuhan UniversityDepartment of Neurology, Renmin Hospital of Wuhan UniversityDepartment of Radiology, Renmin Hospital of Wuhan UniversityDepartment of Neurology, Renmin Hospital of Wuhan UniversityAbstract Background Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic condition which comprises various neurological symptoms. This syndrome could be complicated by intracranial hemorrhage including subarachnoid hemorrhage (SAH). However, SAH is rarely seen in eclamptic patients with PRES. Case presentation A 34-weeks-pregnant woman at the age of 33 was admitted to the obstetrics department because of an episode of generalized tonic-clonic seizure. Before the seizure, the patient had a headache and was found to have an abnormal systolic blood pressure of 160 mmHg. On admission, systolic and diastolic blood pressures were up to 182 and 99 mmHg, respectively. Emergent cesarean section was then performed. On hospital day (HD) 2, cranial non-contrast computed tomography (CT) revealed the existence of SAH. Multiple areas of high signals on T2-weighted and fluid attenuated inversion recovery (FLAIR) sequences were shown by cranial magnetic resonance imaging (MRI) performed 2 days later. CT-angiography studies didn’t reveal intracranial aneurysm. After anti-hypertensive treatment, arterial blood pressure of the patient was gradually tapered to normal values. Eventually, the patient was discharged without any residual symptoms. Conclusions SAH is a rare complication of PRES in eclamptic patients. In patients with PRES, occurrence of SAH is related to increased morbidity and mortality especially when the hemorrhage is diffuse or massive. Our patient had a minor hemorrhage. The good prognosis might also be due to immediate elimination of the risk factor of PRES by emergent delivery.http://link.springer.com/article/10.1186/s12883-018-1186-1Posterior reversible encephalopathy syndromeSubarachnoid hemorrhageEclampsia |
| spellingShingle | Dan Hu Jing Xiong Yunfei Zha Zhaohui Zhang Posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient: case report BMC Neurology Posterior reversible encephalopathy syndrome Subarachnoid hemorrhage Eclampsia |
| title | Posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient: case report |
| title_full | Posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient: case report |
| title_fullStr | Posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient: case report |
| title_full_unstemmed | Posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient: case report |
| title_short | Posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient: case report |
| title_sort | posterior reversible encephalopathy syndrome complicated with subarachnoid hemorrhage in an eclamptic pregnant patient case report |
| topic | Posterior reversible encephalopathy syndrome Subarachnoid hemorrhage Eclampsia |
| url | http://link.springer.com/article/10.1186/s12883-018-1186-1 |
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