Skip to main content
SpringerLink
Log in

Extensive Posterior Reversible Encephalopathy Syndrome in Late-Onset Eclampsia: a Case Report

  • Medicine
  • Published:
SN Comprehensive Clinical Medicine Aims and scope Submit manuscript

Abstract

The posterior reversible encephalopathy syndrome (PRES) is characterized by several neurological signs and symptoms from different pathological causes. The interpretation of magnetic resonance imaging (MRI) is crucial in atypical presentations, to avoid a misdiagnosis and delays in treatment, as in the identification of complicating factors. Differentiating reversible vasogenic edema from cytotoxic edema is possible with diffusion-weighted images (DWI) and apparent diffusion coefficient (ADC) mapping. We present a case of puerperal extensive PRES related to late-onset eclampsia, in a 36-year-old first-time pregnant woman with no previous history of hypertension or other risk factors, associated with a severe clinical picture but with a full recovery in few weeks. We conclude that the prognosis of puerperal PRES should be good, if underlying etiology can be treated satisfactorily, in extensive MRI involvement too.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

Data Availability

De-identified data and material inherent to the case report and not included in the manuscript are available on request to the corresponding author by any qualified investigator.

References

  1. Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996;334:494–500.

    Article  CAS  Google Scholar 

  2. Fisher M, Schmutzhard E. Posterior encephalopathy reversible syndrome. J Neurol. 2017;264:1608–16.

    Article  Google Scholar 

  3. Marcoccia E, Piccioni MG, Schiavi MC, Colagiovanni V, Zannini I, Musella A, et al. Postpartum posterior reversible encephalopathy syndrome (PRES): three case reports and literature review. Case Rep Obstet Gynecol. 2019; Article ID 9527632, 11 pages.

  4. Sardesai S, Dabade R, Deshmukh S, Patil P, Pawar S, Patil A. Posterior reversible encephalopathy syndrome (PRES): evolving the mystery of eclampsia! J Obstet Gynecol India. 2019;69(4):334–8.

    Article  Google Scholar 

  5. Lifson N, Pasquale A, Salloum G, Alpert S. Ophthalmic manifestations of posterior reversible encephalopathy syndrome. Neuro-Ophthalmoloy. 2019;43(3):180–4.

    Article  Google Scholar 

  6. Stevens CJ, Heran MKS. The many faces of posterior reversible encephalopathy syndrome. Br J Radiol. 2012;85:1566–75.

    Article  CAS  Google Scholar 

  7. Cerrone P, Sucapane P, Totaro R, Sacco S, Carolei A, Marini C. Posterior reversible encephalopathy syndrome presenting with atypical findings: report of two cases. Case Rep Neurol Med. 2018; Article ID 7835415, 5 pages.

  8. Saad AF, Chaudhari R, Wintermark M. Imaging of atypical and complicated posterior reversible encephalopathy syndrome. Front Neurol. 2019;10:964.

    Article  Google Scholar 

  9. Samara A, Berry B, Ghannam M. Posterior reversible encephalopathy syndrome with isolated infratentorial involvement: a case report. Radiol Case Rep. 2019;14:576–80.

    Article  Google Scholar 

  10. Masai K, Ueda Y, Naito H, Tsukahara K, Aokage T, Fujisaki N, et al. Atypical case of posterior reversible encephalopathy syndrome related to late onset postpartum eclampsia. A case report. Medicine. 2019;98:16.

    Article  Google Scholar 

  11. Chen Z, Zhang G, Lerner A, Wang AH, Gao B, Liu J. Risk factors for poor outcome in posterior reversible encephalopathy syndrome: systematic review and meta-analysis. Quant Imaging Med Surg. 2018;8(4):421–32.

    Article  Google Scholar 

  12. Zou LP, Liu LY, Li H, Wang YY, Liu Y, Chen J, et al. Establishment and utility assessment of posterior reversible encephalopathy syndrome early warning scoring (PEWS) scale establishment and utility assessment of PEWS scale. BMC Neurol. 2019;19:30.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Neurology Unit, S. Paolo Hospital, ASL Napoli 1 Centro, Via Terracina 219, 80125, Naples, NA, Italy

    Leonardo Sinisi

  2. Naples, Italy

    Leonardo Sinisi

  3. Ophthalmology, Department of Surgery, Medicine, Molecular and Emergency, University of Pisa, Pisa, Italy

    Fabrizio Sinisi

  4. Neuroradiology Unit, Ospedale del Mare, ASL Napoli 1 Centro, Naples, NA, Italy

    Giuseppe Maria Ernesto La Tessa

Authors
  1. Leonardo Sinisi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Fabrizio Sinisi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Giuseppe Maria Ernesto La Tessa
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

L.S.: acquisition of data, analysis and interpretation of data, figure creation, drafted the manuscript for intellectual content. F.S.: analysis and interpretation of data, revised the manuscript for intellectual content; G.M.E.L.T.: acquisition of imaging data.

Corresponding author

Correspondence to Leonardo Sinisi.

Ethics declarations

Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethical Approval

This article does not contain any studies involving human participants performed by any of the authors.

Patient Perspective

The patient shared the perspective on the treatment she received.

Informed Consent

Written informed consent was collected from the patient for the inclusion of de-identified clinical data in a scientific publication, in accordance with the Declaration of Helsinki.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Medicine

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sinisi, L., Sinisi, F. & La Tessa, G.M.E. Extensive Posterior Reversible Encephalopathy Syndrome in Late-Onset Eclampsia: a Case Report. SN Compr. Clin. Med. 2, 2460–2462 (2020). https://doi.org/10.1007/s42399-020-00544-1

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s42399-020-00544-1

Keywords

Search

Navigation