Summary
Two patients with severe cerebral symptoms of toxemia of pregnancy were examined using computed tomography (CT) and angiography. CT disclosed extensive areas of low attenuation within the cerebral hemispheres. Angiography revealed constriction and narrowing of proximal and peripheral vessels suggesting vasculitis with extensive areas of impaired regional cerebral blood flow. A review of the known pathology and the theories regarding the pathophysiology of the cerebral effects of toxemia is presented.
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Sibai BM, McCubbin JH, Anderson GD, Lipshitz J, Dilts PV (1981) Eclampsia. I. Observations from 67 recent cases. Obstet Gynecol 58:609–613
Wiebers DO (1985) Ischemic cerebrovascular complications of pregnancy. Arch Neurol 42:1106–1113
Sheehan HL, Lynch JB (1973) Pathology of toxemia of pregnancy. Williams & Wilkins, Baltimore
Beeson JH, Duda EE (1982) Computed axial tomography scan demonstration of cerebral edema in eclampsia preceded by blindness. Obstet Gynecol 60:529–532
Grimes DA, Ekbladh LE, McCartney WH (1980) Cortical blindness in preeclampsia. Int J Gynecol Obstet 17:601–603
Gaitz JP, Bamford CR (1982) Unusual computed tomographic scan in eclampsia. Arch Neurol 39:66
Kirby JC, Jaindl JJ (1984) Cerebral CT findings in toxemia of pregnancy. Radiology 151:114
Colosimo C, Fileni A, Moschini M, Guerrini P (1985) CT findings in eclampsia. Neuroradiology 27:313–317
Beck RW, Menezes AH (1981) Intracerebral hemorrhage in a patient with eclampsia. JAMA 246:1442–1443
Naheedy MH, Biller J, Schiffer M, Azarkia B, Gianopailous J, Zarandy S (1985) Toxemia of pregnancy: cerebral CT findings. J Comput Assist Tomogr 9:497–501
Chesley LC (1978) Hypertensive disorders in pregnancy. Appleton-Century-Crofts, New York
Zangemeister W (1911) Beitrag zur Auffassung und Behandlung der Eklampsie. Dtsch Med Wochenschr 37:1879–1881
Schmorl G (1902) Zur Lehre von der Eklampsie. Arch Gynecol 65:504
McKay DG (1972) Hematologic evidence of disseminated intravascular coagulation in eclampsia. Obstet Gynecol Surv 27:399–417
McCall ML (1949) Cerebral blood flow and metabolism in toxemias of pregnancy. Surg Gynecol Obstet 89:715–721
Gant NF, Worley RJ (1980) Hypertension in pregnancy concepts and management. Appleton-Century-Crofts, New York
Donaldson JO (1978) Neurology of pregnancy. Saunders, Philadelphia
Landesman R, Douglas RG, Holze E (1954) The bulbar conjunctival vascular bed in toxemias of pregnancy. Am J Obstet Gynecol 68:170–183
Beck RW, Gamel JW, Willcourt RJ, Berman G (1980) Acute ischemic optic neuropathy in severe preeclampsia. Am J Ophthalmol 90:342–346
Lindheimer MD, Katz AI (1981) Pathophysiology of preeclampsia. Ann Rev Med 32:273–289
Bauer TW, Moore GW, Hutchins GM (1982) Morphologic evidence for coronary artery spasm in eclampsia. Circulation 65:255–258
Heilmann L, Siekmann U, Schmid-Schonbein H, Ludwig H (1981) Hemoconcentration and preeclampsia. Arch Gynecol 231:7–21
Sibai BM, Anderson GD, McCubbin JH (1982) Eclampsia II clinical significance of laboratory findings. Obstet Gynecol 59:153–157
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Lewis, L.K., Hinshaw, D.B., Will, A.D. et al. CT and angiographic correlation of severe neurological disease in toxemia of pregnancy. Neuroradiology 30, 59–64 (1988). https://doi.org/10.1007/BF00341945
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DOI: https://doi.org/10.1007/BF00341945