Postpartum Posterior Reversible Encephalopathy Syndrome Secondary to Preeclampsia and Cerebrospinal Fluid Leakage: A Case Report and Literature Review
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Background: Postpartum posterior reversible encephalopathy syndrome (PRES) is not uncommon. Its mechanisms and risk factors are not clear.
Case Summary: A 28-year-old woman underwent cesarean section but had inadvertent dural puncture during epidural anesthesia. To manage the symptoms of intracranial hypotension, crystalloid fluid was infused. However, the patient developed postpartum preeclampsia and PRES. The patient was treated with diazepam and dehydration therapy. The signs of cerebral lesions on magnetic resonance imaging disappeared on postpartum day 7.
Conclusion: Postpartum preeclampsia and PRES can develop concomitantly. Treating postdural puncture headaches with infusion of crystalloid fluid may precipitate the development of PRES.
Lupus nephritis with posterior reversible encephalopathy syndrome as the first manifestation.
Wang W, Chen W, Zhao X, Wu X QJM. 2023; 116(12):1018-1019.
PMID: 37676823 PMC: 10753408. DOI: 10.1093/qjmed/hcad198.