Posterior reversible encephalopathy syndrome (PRES) in a pregnant with blindness: a case report

Yıl 2015, , 76 - 79, 16.03.2015

Ayşe Yasemin Karageyim Karşıdağ , Esra Esim Büyükbayrak , Seda Subaş Erdinç Şişman Seviye Bora Şişman

https://doi.org/10.16948/zktb.38486

Öz

Posterior Reversible Encephalopathy Syndrome (PRES) is characterized by clinical symptoms such as visual disturbance, altered mental status, and seizures. It also presented with abnormal findings on computed tomography (CT) and magnetic resonance imaging (MRI) indicating cerebral edema in the occipital, temporal, and parietal lobes. It is often related with an acute increase in arterial blood pressure, and is associated with preeclampsia, renal failure, infections, and immunosuppressive agents. Early diagnosis and treatment of PRES is very important. PRES is a medical emergency and it is a fully reversible condition especially when diagnosed and treated immediately. Herein we report a case presented with blindness and diagnosed with MRI as PRES.

Anahtar Kelimeler

posteriorreversible encephalopathy syndrome, pregnancy, preeclampsia

Görme kaybı ile başvuran gebede posterior reversibl ensefalopati sendromu (PRES): olgu sunumu

Öz

Posterior Reversibl Enselopati Sendromu (PRES) görme bozuklukları, mental durum bozukluğu ve nöbetler ile seyreden bir sendromdur. Bilgisayarlı tomografi (BT) ve magnetik rezonans (MR) görüntülemede oksipital, temporal ve pariyetal lobda ödem mevcuttur. Sıklıkla ani yükselen ve kompanse edilemeyen arter basıncına bağlı olarak; preeklampsi, böbrek yetmezliği, enfeksiyonlar ve immunosüpressif ilaçlar zemininde gelişir. PRES’in erken tanı ve tedavisi önemlidir. PRES medikal acillerden biridir ve özellikle erken tanı ve hızlı tedavi ile tamamen geri dönüşümlü bir sendromdur. Burada görme kaybı ile başvuran, preeklampsi zemininde gelişen ve MR ile tanısı konulan PRES sendromu olgusunu sunduk.

Anahtar Kelimeler

posterior reversibl ensefalopati sendromu, gebelik, preeklampsi

Kaynakça

• - Thakur R, Sharma BR, Yuan T, Guiying Z. Posterior reversible leukoencephalopathy syndrome in a pre-eclamptic woman. Case Report Obstet Gynecol 2013;2013:783536. doi: 10.1155/2013/783536. Epub 2013 Feb 20.
• - Ural UM, Balik G, Sentürk S, Ustüner I, Cobanoğlu U, Sahin FK. Posterior Reversible Encephalopathy Syndrome in a Postpartum Preeclamptic Woman without Seizure. Case Report Obstet Gynecol 2014;2014:657903. doi: 10.1155/2014/657903. Epub 2014 Jan 30.
• - Ekawa Y, Shiota M, Tobiume T, Shimaoka M, Tsuritani M, Kotani Y, et al. Reversible posterior leukoencephalopathy syndrome accompanying eclampsia: correct diagnosis using preoperative MRI. Tohoku J Exp Med 2012;226(1):55-8.
• - Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med 1996;334(8):494-500
• - Wagner SJ, Acquah LA, Lindell EP, Craici IM, Wingo MT, Rose CH, et al. Posterior reversible encephalopathy syndrome and eclampsia: pressing the case for more aggressive blood pressure control. Mayo Clin Proc 2011;86(9):851-6.
• - Brewer J, Owens MY, Wallace K, Reeves AA, Morris R, Khan M, et al. Posterior reversible encephalopathy syndrome in 46 of 47 patients with eclampsia. Am J Obstet Gynecol 2013;208(6):468.e1-6.
• - Staykov D, Schwab S. Posterior reversible encephalopathy syndrome. Nervenarzt 2012;83(8):1013-20.
• - Amburgey OA, Chapman AC, May V, Bernstein IM, Cipolla MJ. Plasma from preeclamptic women increases blood-brain barrier permeability: role of vascular endothelial growth factor signaling. Hypertension 2010;56(5):1003-8.
• - Euser AG, Cipolla MJ. Magnesium sulfate for the treatment of eclampsia: a brief review.
• Stroke 2009;40(4):1169-75.
• - Loureiro R, Leite CC, Kahhale S, Freire S, Sousa B, Cardoso EF, et al. Diffusion imaging may predict reversible brain lesions in eclampsia and severe preeclampsia: initial experience. Am J Obstet Gynecol 2003;189(5):1350-5.
• - McKinney AM, Short J, Truwit CL, McKinney ZJ, Kozak OS, SantaCruz KS, et al. Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol 2007;189(4):904-12.
• - Do DV, Rismondo V, Nguyen QD. Reversible cortical blindness in preeclampsia. Am J Ophthalmol 2002;134(6):916-8.
• - Plazzi G, Tinuper P, Cerullo A, Provini F, Lugaresi E. Occipital lobe epilepsy: a chronic condition related to transient occipital lobe involvement in eclampsia. Epilepsia 1994;35(3):644-7.
• - Demirtaş O, Gelal F, Vidinli BD, Demirtaş LO, Uluç E, Baloğlu A. Cranial MR imaging with clinical correlation in preeclampsia and eclampsia. Diagn Interv Radiol 2005;11(4):189-94.
• - Akgün N, Karaman M, Başyiğit S, Yılmaz H, Özcan AA. Posterior reversbl ensefalopati: 2 olgu sunumu. İstanbul Tıp Dergisi 2010;2:82-85.
• - Günyeli İ, Erdemoğlu E, Güney M, Mungan T. Yirmi altı haftalık gebelikte preeklampsiye sekonder posterior revesibl ensefalopati (PRES): Bir olgu sunumu. JOPP Dergi 2012;4:80-84.
• - Aygün BK, Baykuş Y, Berilgen S, Kavak B, Celik H, Gürateş B. Posterior Reversible Encephalopathy Syndrome in severe preeclampsia: case report and literature review. J Turk Ger Gynecol Assoc 2010;11(4):216-9.
• - Keiser SD, Owens MY, Parrish MR, Cushman JL, Bufkin L, May WL, et al. HELLP syndrome with and without eclampsia. Am J Perinatol 2011;28(3):187-94.