Delayed diagnosis of posterior reversible encephalopathy syndrome (PRES) in a parturient with preeclampsia after inadvertent dural puncture

2007 ◽  
Vol 16 (2) ◽  
pp. 171-174 ◽  
Author(s):  
T.M. Torrillo ◽  
D.J. Bronster ◽  
Y. Beilin
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Dural Puncture ◽  
Delayed Diagnosis ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

scholarly journals Posterior Reversible Encephalopathy Syndrome in Pregnancy

2015 ◽  
Vol 7 (3) ◽  
pp. 205-206
Author(s):  
N Sundari ◽  
Asha Swaroop ◽  
BM Krupa ◽  
BK Madhusudhan ◽  
S Chaitra
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Delayed Diagnosis ◽  
Acute Onset ◽  
Posterior Reversible Encephalopathy ◽  
Complete Reversal ◽  
The Common ◽  
T2 Hyperintensity ◽  
Reversible Encephalopathy ◽  
Visual Disturbances ◽  
In Pregnancy

ABSTRACT Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity characterized by several symptoms of varied etiologies. The common symptoms are headache, confusion, seizures, cortical visual disturbances or blindness. Here, we report a 22 years old lady with 32 weeks of gestation who presented with complaints of acute onset of headache, sudden loss of vision with elevated blood pressure (BP), whose magnetic resonance venogram (MR venogram) revealed bilateral occipital T2 hyperintensity with restriction of diffusion suggestive of PRES. Early identification and treatment usually results in complete reversal of the deficits and delayed diagnosis and improper management can lead to irreversible sequelae. How to cite this article Krupa BM, Sundari N, Madhusudhan BK, Swaroop A, Chaitra S. Posterior Reversible Encephalopathy Syndrome in Pregnancy. J South Asian Feder Obst Gynae 2015;7(3):205-206.

scholarly journals A Case of Postpartum Headache Post Dural Puncture. Post Dural Puncture Headache or Reversible Cerebral Vasoconstriction Syndrome - Posterior Reversible Encephalopathy Syndrome?

2020 ◽  
Author(s):  
Melania Turetti ◽  
Maria Barbagallo ◽  
Umberto Scoditti ◽  
Antonio Genovese ◽  
Laura Angeli ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Dural Puncture ◽  
Postpartum Woman ◽  
Unexpected Event ◽  
Post Dural Puncture Headache ◽  
Posterior Reversible Encephalopathy ◽  
Cerebral Vasoconstriction ◽  
Reversible Encephalopathy ◽  
Prompt Diagnosis ◽  
Postpartum Headache

Abstract BACKGROUNDReversible Cerebral Vasoconstriction Syndrome (RCVS) and Posterior Reversible Encephalopathy Syndrome (PRES) are two rare neurological conditions, clinically characterized of headache. This is sometimes difficult to differentiate from post dural puncture headache (PDPH). In our case a diagnosis of PDPH was made but imaging showed signs of RCVS-PRES. The novelty is that, unlike in cases reported in literature, no liquoral hypotension signs were detected on imaging.CASE PRESENTATIONWe present a case of RCVS-PRES in a postpartum woman that presented headache as first symptom, and only later experienced seizures. Epidural analgesia was performed during labour, and it was complicated by dural puncture that worked as a confounding factor in the clinical postpartum evaluation. Seizures represented an unexpected event in the course of treating this patient for post dural puncture headache.CONCLUSIONSWe point out the attention on changes of clinical characteristics of headache as an important factor to be analyzed, in order to have a prompt diagnosis. Moreover, we evaluate possible triggers of RCVS and PRES; in our case dural puncture is probably not the trigger, in fact there were no liquoral hypotension signs on imaging. According to literature reports, puerperium itself was a promoting factor.

Delayed Diagnosis of Posterior Reversible Encephalopathy Syndrome

2020 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Roma Pegany ◽  
Daniel J. Olson ◽  
Khalid M. Aldaas ◽  
Kevin R. Sitko
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Delayed Diagnosis ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

scholarly journals Kejang Post Partum di Rumah Sakit Tipe B: sebuah Manajemen Kasus Multidisiplin

2021 ◽  
Vol 4 (2) ◽  
Author(s):  
Ketut Mahendera Barata ◽  
Mariza Fitriati ◽  
Hisbullah Hisbullah ◽  
Faisal Faisal ◽  
Haizah Nurdin
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Dural Puncture ◽  
Post Partum ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Cerebrovasculair Accident

Kejang post partum masih merupakan kasus utama penyebab morbiditas dan mortalitas maternal diseluruh dunia. Diagnosis banding penyebab kejang antara lain kejang akut, gangguan metabolik, hipoglikemi dan hipo/hipernatremia, jejas otak traumatik, iskemia otak sesaat ataupun cerebrovasculair accident, perdarahan intrakranial, perdarahan subarachnoid, meningitis, ensefalitis, eklampsia, gejala akut kecanduan alkohol, gejala akut kecanduan benzodiazepine atau barbiturate, dural puncture, dan posterior reversible encephalopathy syndrome (PRES). Pada pasien ini terjadi kejang pada hari kedelapan post partum, dengan penyebab utama kejang berasal dari masalah kardiovaskular. Manajemen kejang pada pasien ini dimulai dengan upaya resusitasi cairan, dilanjutkan pengelolaan dukungan airway-breathing-circulation, dan kemudian penyingkiran kandidat diagnosis terhadap infeksi Covid-19, Mendelson syndrome, infeksi lain, gangguan keseimbangan elektrolit, dll. Kerjasama multidisiplin dokter spesialis sangat membantu pencapaian kesembuhan, meskipun masih perlu dilakukan pemeriksaan lanjutan terutama bila ada perencanaan kehamilan berikutnya.  

scholarly journals Posterior Reversible Encephalopathy Syndrome as a Postpartum Complication

2018 ◽  
Vol 6 (5) ◽  
pp. 851-854
Author(s):  
Samra Kadić-Vukas ◽  
Mirsada Hodžić ◽  
Lejla Tandir-Lihić ◽  
Lejla Hrvat ◽  
Azra Kožo-Kajmaković ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Epileptic Seizures ◽  
Posterior Reversible Encephalopathy ◽  
Endotracheal Anaesthesia ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
The Brain ◽  
Visual Disturbances

BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome with seizures, altered consciousness, visual disturbances and headache among other symptoms. Hinchey et al. first described Pres in 1996, with two other case series published shortly after.CASE REPORT: A 23-year-old women patient was emergency sent from General Hospital Tešanj due to a crisis of consciousness and repeated epileptic seizures. The patient had a second birth before 10 days (postpartum cesarean) in general endotracheal anaesthesia (two cesarean-born babies). On magnetic resonance imaging (MRI) of cranium described both sides of the symmetrically frontal, parietal (and pre-ventricular gyri) and occipitally visible T2W/FLAIR hyperintensity focuses on the cortex and the thin layer of white mass subcortically. In the projection of the lesions parts, discrete DWI hyperintensity is seen without a reliable ADC correlate. The patient improved after management with intravenous fluids, antibiotics, antiepileptics and monitoring of blood pressure. According to latest experiences delayed diagnosis and treatment may lead to mortality or irreversible neurological deficit. Aggravating circumstances are differential diagnoses that include cerebral infarction (ischemic, haemorrhage), venous thrombosis, vasculitis, pontine or extrapontine myelinolysis.CONCLUSION: MRI of the brain is key to make this distinction with crucial recognition and an open mind from radiology and neurology specialist.

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