Posterior reversible encephalopathy syndrome (PRES) in critically ill obstetric patients

Servillo, Giuseppe; Striano, Pasquale; Striano, Salvatore; Tortora, Fabio; Boccella, P.; Robertis, Edoardo De; Rossano, F.; Briganti, Francesco; Tufano, R

doi:10.1007/s00134-003-1901-1

Cited by 109 publications

(102 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…PRES PRES (Fig 7) is a clinical and neuroradiologic entity of various origins, characterized by a variety of symptoms, including headache, altered mental status, visual loss, seizures, and loss of consciousness. [54][55][56][57] CT and MR imaging typically demonstrate bilateral predominantly posterior cerebral edema, which is usually shown on DWI to be of vasogenic origin. 55,56 When present, the cytotoxic edema is reported to be associated with an adverse outcome.…”

Section: 52mentioning

confidence: 99%

Isolated Acute Nontraumatic Cortical Subarachnoid Hemorrhage

Cuvinciuc¹,

Viguier²,

Calvière³

et al. 2010

AJNR Am J Neuroradiol

127

108

View full text Add to dashboard Cite

SUMMARY:Our aim was to review the etiologic background of isolated acute nontraumatic cSAH. While SAH located in the basal cisterns originates from a ruptured aneurysm in approximately 85% of cases, a broad spectrum of vascular and even nonvascular pathologies can cause acute nontraumatic SAH along the convexity. Arteriovenous malformations or fistulas, cortical venous and/or dural sinus thrombosis, and distal and proximal arteriopathies (RCVS, vasculitides, mycotic aneurysms, Moyamoya, or severe atherosclerotic carotid disease) should be sought by noninvasive imaging methods or/and conventional angiography. Additionally, PRES may also be a source of acute cSAH. In elderly patients, cSAH might be attributed to CAA if numerous hemorrhages are demonstrated by GRE T2 images. Finally, cSAH is rarely observed in nonvascular disorders, such as abscess and primitive or secondary brain tumors.ABBREVIATIONS: CAA ϭ cerebral amyloid angiopathy; cSAH ϭ cortical subarachnoid hemorrhage; CTA ϭ CT angiography; CTV ϭ CT venography; CVT ϭ cerebral venous thrombosis; DSA ϭ digital subtraction angiography; DWI ϭ diffusion-weighted imaging; FLAIR ϭ fluid-attenuated inversion recovery; Gd ϭ gadolinium; GRE T2 ϭ gradient echo T2-weighted imaging; MRA ϭ MR angiography; MRV ϭ MR venography; PRES ϭ posterior reversible encephalopathy syndrome; RCVS ϭ reversible cerebral vasoconstriction syndrome; SAH ϭ subarachnoid hemorrhage; SWI ϭ susceptibility-weighted imaging; TIA ϭ transient ischemic attack; TOF ϭ time of flight N ontraumatic (spontaneous) SAH arises in approximately 85% of cases from rupture of a saccular aneurysm at the base of the brain. Nonaneurysmal perimesencephalic hemorrhages account for another 10%.

show abstract

Section: 52mentioning

confidence: 99%

Isolated Acute Nontraumatic Cortical Subarachnoid Hemorrhage

Cuvinciuc¹,

Viguier²,

Calvière³

et al. 2010

AJNR Am J Neuroradiol

127

108

View full text Add to dashboard Cite

show abstract

“…Most of them delivered preterm (27 out of 30). The median gestational age at delivery was 34 (31)(32)(33)(34)(35)(36) weeks. In the present study, 17 (57%) patients were delivered by caesarean sections 13 (43%) patients delivered vaginally.…”

Section: Resultsmentioning

confidence: 99%

“…The outcome of pregnant women with PRES was usually reported as favorable, with resolution being rapid and complete after adequate therapy, although permanent damage can persist, and death due to hemorrhage was described. 34,35 Admission of PRES patients to the ICU is advisable, to allow optimum patient monitoring and prevention of possible complications. In the present study 53.3% of our patients had eclampsia related complications and 36.7% required ICU care as compare to study done by Manvi PJ 11% required ICU care.…”

Section: Figure 2a 2b 2c and 2d: Mri Images Of One Of The Patients mentioning

confidence: 99%

Maternal and perinatal outcome in eclampsia complicated by posterior reversible encephalopathy syndrome; a three years’ experience in a tertiary care hospital

Karanth

Gonsalves

Sheela

et al. 2017

Int J Reprod Contracept Obstet Gynecol

View full text Add to dashboard Cite

Background: PRES can be associated with number of medical conditions and was observed frequently in patients with preeclampsia and eclampsia. Neuroimaging is important for the diagnosis of PRES. Study was conducted to find out the maternal and perinatal outcome in patients with eclampsia complicated by posterior reversible encephalopathy syndrome (PRES).Methods: This is a retrospective study done at St. Johns Medical College Bangalore, between October 2013 and October 2016. We reviewed case records of all the patients with eclampsia who underwent neuro imaging studies and a diagnosis of PRES was made. The maternal and perinatal outcomes in these women were studiedResults: In the past three years we had 55 cases of eclampsia who underwent neuroimaging studies for persistent neurological symptoms after 24 hours of MgSO4 treatment. Of these women 30 were diagnosed to have PRES. In the present study PRES was common in multiparous women and more in patients with antepartum eclamptic women. Mean age at diagnosis of PRES was 26±5.1 years. Common presenting symptoms were headache (93.3%) and vomiting (53.3%). The mean SBP/DBP was 180/110 mmHg. All patients who had recurrent seizures were controlled with MgSO4 alone. 53.3% of our patients had eclampsia related complications and 36.7% required ICU care. There were 3 maternal deaths (10%). Perinatal mortality was 20%.Conclusions: Neuroimaging in eclamptic patients with persistent neurological symptoms could help in early diagnosis of PRES and multidisciplinary approach in management could contribute significantly in reducing the maternal mortality and morbidity.

show abstract

“…Other medications include analgesics for headaches and anticonvulsants for seizure prevention and treatment. For non-pregnant patients experiencing seizure, benzodiazepines (such as lorazepam or diazepam) are considered as first-line drugs, and they provide rapid onset and therapeutic benefits (8). Magnesium sulfate is considered to be the drug of choice for seizures in pregnancy (9).…”

Section: Discussionmentioning

confidence: 99%

“…Magnesium sulfate is considered to be the drug of choice for seizures in pregnancy (9). Uncontrollable seizure activity may require a higher level of care, intensive care monitoring, and support (8).…”

Section: Discussionmentioning

confidence: 99%