Late Occurrence of Diffuse Cerebral Swelling After Intracerebral Hemorrhage in a Patient With the HELLP Syndrome —Case Report—

Kimiaki HASHIGUCHI; Takanori INAMURA; Kazuo IRITA; Michie ABE; Eiichiro NODA; Shigeaki YANAI; Shosuke TAKAHASHI; Masashi FUKUI

doi:10.2176/nmc.41.144

Case Reports

Late Occurrence of Diffuse Cerebral Swelling After Intracerebral Hemorrhage in a Patient With the HELLP Syndrome

—Case Report—

Kimiaki HASHIGUCHI, Takanori INAMURA, Kazuo IRITA, Michie ABE, Eiichiro NODA, Shigeaki YANAI, Shosuke TAKAHASHI, Masashi FUKUI

Author information

Kimiaki HASHIGUCHI
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
Takanori INAMURA
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University
Kazuo IRITA
Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University
Michie ABE
Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University
Eiichiro NODA
Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University
Shigeaki YANAI
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kyushu University
Shosuke TAKAHASHI
Department of Anesthesiology and Critical Care Medicine, Graduate School of Medical Sciences, Kyushu University
Masashi FUKUI
Department of Neurosurgery, Graduate School of Medical Sciences, Kyushu University

Keywords: cerebral swelling, HELLP syndrome, hypothermia, intracerebral hemorrhage

JOURNAL OPEN ACCESS

2001 Volume 41 Issue 3 Pages 144-148

DOI https://doi.org/10.2176/nmc.41.144

Details

Abstract

Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome can occur at any time in the course of pregnancy and is associated with many complications including fatal stroke. A 37-year-old female presented with HELLP syndrome causing an intracerebral hematoma, which was treated by evacuation and mild hypothermia. Unexpected diffuse cerebral swelling occurred on the 15th day of the initially favorable postoperative course. Considerable impairment of consciousness persisted despite conservative therapy. Serial computed tomographic findings indicated delayed cerebral vasospasm as the cause of the swelling. Particularly careful management is required even beyond the first 2 weeks for patients with stroke as a complication of HELLP syndrome.

Corresponding author

Register with J-STAGE for free!