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Posterior reversible leucoencephalopathy syndrome: a rare complication of preeclampsia

  • Emmanuel Kalu , Elizabeth Sherriff , J. Valmai Cook and Carolyn Croucher
Published/Copyright: February 1, 2006

Abstract

Complete loss of vision on the delivery suit is a worrying and unusual experience for patients and clinicians. Sudden total blindness, associated with confusion and hemiparesis is even more so, and this is what obtains in Posterior Reversible Leucoencephalopathy Syndrome (PRES).

PRES is a recently recognized syndrome characterized clinically by headache, altered mental status, seizures, cortical blindness and other focal neurological signs, with imaging findings of bilateral cortical and subcortical changes on CT and MRI.

This syndrome has been reported in a number of clinical conditions characterized by either an acute elevation of blood pressure or treatment with certain drugs.

We report a case of cortical blindness, altered mental status and hemiparesis in a 34 year old woman with severe pre-eclampsia complicated by PRES in the puerperium. Abnormalities were demonstrated on CT and MRI with persistent unusual ischemic hyperintensity on T1 weighted MRI imaging thought to correspond with a specific reactive astrocytosis unlike that seen in typical infarction or hemorrhage.

It is important for clinicians to be aware of this rare complication of pre-eclampsia, as early recognition will facilitate treatment and prevent permanent neuronal damage.

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Corresponding author: Dr Emmanuel Kalu Assisted Conception Unit St Helier University Hospital Wrythe lane Carshalton Surrey SM5 1AA, England, UK

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Published Online: 2006-02-01
Published in Print: 2006-02-01

©2006 by Walter de Gruyter Berlin New York

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