Posterior reversible encephalopathy syndrome (PRES) in pregnancy: A diagnostic challenge to obstetricians

Krishnamoorthy, U; Sarkar, Paritosh Kumar; Nakhuda, Y E; Mullins, Paul D.

doi:10.1080/01443610802716026

Cited by 11 publications

(14 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…It includes severe neurological conditions such as cerebrovascular disorders, particularly ischaemic and haemorrhagic stroke or cerebral venous sinus thrombosis (CVTS), cerebral artery dissection [15,[18][19][20][21][22][23][24][25]. Other differential diagnosis are partial seizure, migraine, infection (encephalitis and meningitis) [15,20], inflammatory or autoimmune diseases like vasculitis [15,19,24], metabolic and demyelinating disorders [19,23] ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum

Cozzolino

Bianchi

Mariani

et al. 2015

Arch Gynecol Obstet

View full text Add to dashboard Cite

Purpose Posterior reversible encephalopathy syndrome (PRES) is an usually reversible neuro-radiological clinical entity characterized by headache, confusion, visual disturbances or blindness and seizures. It rarely occurs without seizures. Methods We conducted a literature review in MEDLINE about PRES during post partum and pregnancy, focusing on differential diagnosis and therapy. We reviewed 28 articles (case reports, original articles and reviews) describing PRES as well as a case of a severe, immediate postpartum HELLP syndrome (haemolysis, elevated liver enzyme levels, low platelet count) with PRES without generalized seizure. Results The development of PRES after delivery is unusual. Magnetic resonance imaging represents the gold standard for the diagnosis of this condition. White matter oedema in the posterior cerebral hemispheres is typical on neuroimaging. PRES is reversible when early diagnosis is established and appropriate treatment is started without delay. The pathogenesis of PRES is discussed and the importance of a prompt diagnosis is emphasized, as the crucial role of rapid blood press reduction. Conclusion MRI is the diagnostic gold standard and it may be useful in the differential diagnosis. The goal of the therapy is to control elevated blood pressure and to prevent seizures or promptly manage it.

show abstract

Section: Discussionmentioning

confidence: 99%

Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum

Cozzolino

Bianchi

Mariani

et al. 2015

Arch Gynecol Obstet

View full text Add to dashboard Cite

show abstract

“…In another paper, two patients were described who experienced PRES in the late postpartum period without classical preeclamptic signs but with impairment of consciousness and epileptic seizures (15). PRES should be considered in the differential diagnosis of postpartum seizures (16). In our case no seizure or loss of consciousness occurred.…”

Section: Discussionmentioning

confidence: 96%

Posterior Reversible Encephalopathy Syndrome in severe preeclampsia: case report and literature review

Aygün¹,

Baykuş²,

Berilgen³

et al. 2010

J Turkish German Gynecol Assoc

View full text Add to dashboard Cite

ÖzetWe describe a 23 year old primigravid patient with severe preeclampsia complicated by posterior reversible encephalopathy syndrome (PRES), who presented with sensory and motor deficits and amnesia in the postpartum period Cranial magnetic resonance imaging (MRI) showed abnormal areas in the white matter of bilateral parieto-occipital lobes, indicating brain edema which disappeared completely on the follow-up scan taken four weeks after delivery together with complete symptom regression. The development of PRES in preeclampsia is discussed and the importance of prompt postpartum blood pressure control is emphasized.(J Turkish-German Gynecol Assoc 2010; 11: 216-9) Bu yazıda 23 yaşında, ilk gebeliği olan şiddetli preeklamptik bir hastada postpartum dönemde duyusal ve motor sinir bulguları ve unutkanlık ile ortaya çıkan bir posterior reverzibl ensefalopati sendromu (PRES) sunulmuştur. Kranyal manyetik rezonans görüntüleme (MRI) ile bilateral parieto-occipital loblarda beyin ödemine işaret eden anormal alanlar görülmüş olup, doğumdan dört hafta sonra kontrol amaçlı yapılan görüntüleme testi ile bu lezyonların tamamen kaybolduğu ve semptomların da gerilediği tespit edilmiştir. Preeklampside PRES gelişimi tartışılarak, bu hastalarda postpartum kan basıncı kontrolünün önemi vurgulanmıştır.

show abstract

“…The syndrome was initially recognized in association with severe hypertension, autoimmune disease, malignancy, immunosuppressive therapy or pregnancy [4,5]. High blood pressure was regarded as the major trigger factor in these patients.…”

Section: Discussionmentioning

confidence: 99%

“…In 2000, Casey et al [2] performed a study on the neuroimaging findings of this syndrome and they proposed the term posterior reversible encephalopathy syndrome (PRES) to stress the common involvement of both the grey and white matter. In the field of anesthesiology, there are several reported cases of PRES during cesarean section or after insertion of epidural PCA in pregnant women with preeclampsia or eclampsia [3-5]. However, there has been no report about PRES in non-obstetric patients after general anesthesia.…”

mentioning

confidence: 99%

Posterior reversible encephalopathy syndrome in an untreated hypertensive patient after spinal surgery under general anesthesia -A case report-

Kim

et al. 2011

Korean J Anesthesiol

View full text Add to dashboard Cite

Posterior reversible encephalopathy syndrome (PRES) is an unfamiliar term to anesthesiologists, and this is characterized by neurologic symptoms that include mental change, headache, seizure and visual disturbance and also abnormal neuroimaging finding. A 71-year-old female patient was operated on for posterior decompression and total laminectomy under general anesthesia for the spinal stenosis. After the operation, she developed generalized tonic-clonic seizure and a stuporous mentality in the recovery room. The magnetic resonance imaging (MRI) revealed swelling and increased signal intensity at the deep gray nuclei, cerebral cortex and cerebellum. After one week, she returned to an alert mentality and then she was diagnosed with PRES. She was discharged without any neurologic deficit on postoperative day 20. This report describes our experience with PRES after spinal surgery was performed under general anesthesia on a suspected untreated hypertensive patient.

show abstract

Posterior reversible encephalopathy syndrome (PRES) in pregnancy: A diagnostic challenge to obstetricians

Cited by 11 publications

References 6 publications

Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum

Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum

Posterior Reversible Encephalopathy Syndrome in severe preeclampsia: case report and literature review

Posterior reversible encephalopathy syndrome in an untreated hypertensive patient after spinal surgery under general anesthesia -A case report-

Contact Info

Product

Resources

About