Erschienen in:
02.02.2017 | Original Article
Posterior reversible encephalopathy syndrome in pregnancy: a retrospective series of 36 patients from mainland China
verfasst von:
Y. Wen, B. Yang, Q. Huang, Y. Liu
Erschienen in:
Irish Journal of Medical Science (1971 -)
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Ausgabe 3/2017
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Abstract
Background
Posterior reversible encephalopathy syndrome (PRES) is associated with variable predisposing risk factors including preeclampsia and eclampsia since it proposed. However, studies of large case series focusing on pregnancy-related PRES are still limited. We performed a large retrospective study of patients with pregnancy-related PRES admitted to our institution.
Methods
This was a single-center, 2010–2015 retrospective cohort study of patients with pregnancy-related PRES who underwent neuroimaging via magnetic resonance imaging or computerized tomography from mainland China.
Results
26 of 28 women with eclampsia and 7 of 59 women with preeclampsia had confirmed PRES. A total of 36 patients were finally included as confirmed pregnancy-related PRES in this research. Acute hypertension was present in 31 patients (86%). Headache was the most common presenting symptom (81%) followed by seizures (73%), altered mental status (57%), nausea/vomiting (47%) and visual disturbance (33%). Atypical involved regions included frontal lobe (72%), temporal lobe (67%), basal ganglia (50%), cerebellum (47%), brain stem (14%) and thalamus (8%). Atypical neuroimaging features included restricted diffusion (33%), contrast enhancement (19%) and hemorrhage (19%). Comorbidities included thrombocytopenia (25%), pulmonary infection (25%), anemia (19%), fever (17%), acute renal failure (8%), HELLP syndrome (6%), DIC (6%). Most of patients recovered completely with timely diagnosis and treatment. Two patients who suffered DIC finally died.
Conclusions
Patients with pregnancy-related PRES may present with atypical neuroimaging findings. Moreover, our data supported the view that nearly all imaged patients with eclampsia had clinical and radiologic findings of PRES.