Posterior Reversible Encephalopathy Syndrome with Vision Loss Secondary to Postpartum Eclampsia

Abstract

Posterior reversible encephalopathy syndrome PRES is a rare maternal complication that may occur during pregnancy and the postpartum period. This syndrome may be characterized by headache, altered consciousness, seizures, changes in vision or visual field, nausea and vomiting. PRES is a neuroradiological diagnosis based on the presence of hyperintense signal changes cerebral edema without diffusion restriction in T2 / FLAIR series of cranial magnetic resonance imaging, especially on the parieto-occipital areas. PRES pathogenesis is not yet fully understood, vasospasm resulting from acute increased blood pressure is thought to be the main factor. In defined cases brain lesions were often detected in posterior areas. Early diagnosis and treatment is very important in PRES. Late diagnosis can cause serious neurological sequelaes such as permanent brain damage, chronic epilepsy. The control of blood pressure is essential in the treatment of PRES.

Keywords

• Eclampsia,complications,postpartum,PRES

Postpartum Eklampsiye Sekonder Görme Kaybı ile Komplike Posterior Reversible Ensefalopati Sendromu

Abstract

Posterior reversible ensefelopati sendromu PRES gebelikte ve postpartum dönemde oluşabilecek nadir maternal komplikasyonlardandır. Bu sendrom baş ağrısı, bilinçte değişiklik, nöbet, görmede yada görme alanında değişiklik, bulantı ve kusma ile karakterize olabilmektedir. PRES nöroradyolojik bir tanı olup kranial manyetik rezonans görüntülemede özellikle parieto-oksipital alanlarda T2/FLAIR serilerde hiperintens serebral ödem ve difüzyon kısıtlamasının izlenmediği sinyal değişiklikleri tespit edilmektedir. PRES patogenezi henüz tam anlaşılamamış olup akut kan basıncı artışı sonucu oluşan vazospazmın asıl faktör olduğu düşünülmektedir. Tanımlanan vakalarda beyin lezyonları sıklıkla posterior alanda saptanmıştır. PRES’de erken teşhis ve tedavi oldukça önemlidir. Geç teşhis alındığında kalıcı beyin hasarı, kronik epilepsi gibi ciddi nörolojik sekellere neden olabilir. PRES tedavisinde kan basıncının kontrol altına alınması temeldir.

Keywords

• Eklampsi,komplikasyon,postpartum,PRES

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