A Case of Posterior Reversibl Encephalopathy Syndrome (PRES) During the Postpartum Period

Abstract

Scientific BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a clinical picture that may develop due to eclampsia-preeclampsia, hypertension, drug intoxications and many metabolic diseases. Vasogenic edema developing on brain tissue due to etiologic factors constitutes the basis of pathophysiology. The sympathetic stimulation which defends brain against high acute blood pressure is more insufficient in the posterior circulation system of the brain than the anterior system. Diagnosis is made through history, clinical findings and neuroradiological examinations. Hyperintense lesions observed in posterior regions of brain on T2 weighted sections in cranial magnetic resonance imaging (MRI) may appear as hypo or hyperintense in ADC (apparent diffusion coefficient) images depending on the type of edema. Edema may rarely be detected in cerebellum, brain stem, basal ganglions and frontal regions.

CASE: A 28 year-old female case was hospitalized in our clinic with diagnosis of status epilepticus developing at the eleventh postpartum hour while she was being followed up in obstetrics and gynecology clinic following cesarean operation in her second pregnancy. No pathological finding was detected in follow up of the case who was under physician control in both of her pregnancies, high tension arterial (180/100 mmHg) was detected once during the cesarean operation but then it got back to normal values.

OBJECTIVE: This paper presents a case diagnosed as PRES with clinical and radiological findings and status epilepticus during the postpartum period, but with no risk factor other than a single hypertensive attack, and discusses the case along with the literature.