Advertisement

Central PRES (posterior reversible encephalopathy syndrome) in HELLP syndrome

  • Mihaela Ionela Sarbu
  • Nicolae Sarbu
CE - MEDICAL ILLUSTRATION
  • 19 Downloads

Case presentation

A 24-year-old woman at 35-weeks of pregnancy with haemolysis, elevated liver enzymes and low platelets (HELLP syndrome), in the context of severe pre-eclampsia with high blood pressure (180/110 mmHg), suddenly complained of drowsiness and extreme weariness in the upper and lower limbs with gait difficulties. A computed tomography (CT) examination was performed, showing bilateral symmetric hypodensity of the basal ganglia, without contrast enhancement (Fig.  1a). Subsequent magnetic resonance imaging (MRI) showed hypointense areas on T1-weighted imaging (WI) (Fig.  1b) and high intensity on T2WI and FLAIR sequences (Fig.  1c, d), consistent with vasogenic oedema involving symmetrically the lenticular and caudate nuclei, and with extension to the internal and external capsule. A mild diffusion restriction indicating cytotoxic oedema was present in some areas (Fig.  1e, f). MRI angiography (not shown) showed permeability of the venous system. After pregnancy interruption,...

Notes

Funding

This publication received no specific grant or any other funding.

Compliance with ethical standards

Conflict of interest

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Statement of human and animal rights

All procedures related to this report were in accordance with the ethical standards of the institutional and national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

The informed consent was obtained from the patient in order for her anonymized data to be used for publication.

References

  1. 1.
    Schweitzer AD, Parikh NS, Askin G et al (2017) Imaging characteristics associated with clinical outcomes in posterior reversible encephalopathy syndrome. Neuroradiology 59(4):379–386CrossRefGoogle Scholar
  2. 2.
    Sarbu N, Shih RY, Jones RV et al (2016) White matter diseases with radiologic-pathologic correlation. Radiographics 36(5):1426–1447CrossRefGoogle Scholar
  3. 3.
    Kim DM, Lee IH, Song CJ (2016) Uremic encephalopathy: MR imaging findings and clinical correlation. Am J Neuroradiol 37(9):1604–1609CrossRefGoogle Scholar
  4. 4.
    Godinho MV, Pires CE, Hygino da Cruz LC Jr. (2018) Hypoxic, toxic, and acquired metabolic encephalopathies at the emergency room: the role of magnetic resonance imaging. Semin Ultrasound CT MR 39(5):481–494CrossRefGoogle Scholar

Copyright information

© Società Italiana di Medicina Interna (SIMI) 2018

Authors and Affiliations

  1. 1.Department of Rheumatology“Saint Pierre” University Hospital, and Erasme HospitalBrusselsBelgium
  2. 2.Department of NeuroradiologyErasme Hospital, University of Brussels (ULB)BrusselsBelgium

Personalised recommendations