A bstract: A young woman 4 days postpartum was admitted after experiencing two seizures. Her mentation waxed and waned until, after several hours, staff were unable to arouse her with voice or touch. A computed tomography scan demonstrated considerable white-matter edema. The patient's condition declined to a coma. She remained comatose despite therapeutic interventions to control increased intracranial pressure. To her family, her condition was a source of anguish. To the physicians and nurses, she was a puzzle. The final diagnosis was posterior reversible encephalopathy syndrome, which was related to a preeclamptic condition and its associated hypertension. The collaboration of obstetricians and neurologists with vigilant care by neuroscience nurses resulted in a positive outcome for this challenging patient.The case study presented here was particularly challenging, not only because of the puzzling constellation of signs and symptoms, but because the issues overlapped two distinct specialty areas: obstetrics and neurology. The collaboration involved in diagnosing the illness and treating it aggressively and effectively demanded all the physicians' expertise. The nurses were equally diligent in their observations, assessments, and care. They were determined to return this patient to her family and newborn child. The discussion includes presenting signs and symptoms, detailed assessment findings, diagnostic test results, the medical diagnosis, and patient outcomes. Major nursing issues and interventions are identified throughout the discussion.
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