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Neurological manifestations and neuroimaging presentations in patients with severe preeclampsia: predisposing factors and clinical implications

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Abstract

Background and purpose

Neurological manifestations and neuroimaging abnormalities are common in patients with severe preeclampsia; however, the differences between these abnormal features occurring during early- and late-onset severe preeclampsia are unclear, and the factors associated with abnormal imaging changes in patients with neurological manifestations have not yet been fully elucidated.

Materials and methods

A retrospective study was conducted on 172 patients with severe preeclampsia from January 2017 to June 2018 in the Department of Neurology and Obstetrics, Shengjing Hospital of China Medical University. The neurological manifestations, clinical parameters, laboratory, and neuroimaging findings were analyzed.

Results

Early- and late-onset preeclampsia were diagnosed in 83 and 89 patients, respectively. Headache and dizziness were more common in patients with early-onset preeclampsia than in patients with late-onset preeclampsia (p = 0.013, p = 0.004, respectively). Serum uric acid, creatinine, and urea nitrogen were significantly elevated in the patients with early-onset preeclampsia (p < 0.001, p = 0.004, and p = 0.005, respectively). Neuroimaging was performed in 81 patients, of which 57 were positive. Findings indicating cerebral edema were the most common neuroimaging abnormality. Gestational weeks (p = 0.014), headache (p < 0.001), and blood urea nitrogen level (p = 0.027) may be associated with positive imaging findings. By multiple logistic regression, headache (OR = 10.2, 95% CI, 2.4–42.7; p = 0.002) proved to be an independent factor associated with neuroimaging abnormality.

Conclusions

Neurological symptoms such as headache and dizziness were more common in patients with early-onset preeclampsia. Renal dysfunction may also associate with early-onset severe preeclampsia. Cerebral edema was the most common neuroimaging abnormality, and headache might be independently associated with abnormal imagine changes.

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Authors and Affiliations

  1. Department of Neurology, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, 110004, Shenyang, Liaoning, People’s Republic of China

    Xiaoyu Dong & Jianfei Nao

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  1. Xiaoyu Dong
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  2. Jianfei Nao
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Correspondence to Jianfei Nao.

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Dong, X., Nao, J. Neurological manifestations and neuroimaging presentations in patients with severe preeclampsia: predisposing factors and clinical implications. Neurol Sci 40, 1245–1253 (2019). https://doi.org/10.1007/s10072-019-03833-3

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