A 25-Year-Old 6 Hours’ Postpartum with Severe Hypertension, Seizures, and Confusion

doi:10.1017/9781009413787.075

Case 73 - A 25-Year-Old 6 Hours’ Postpartum with Severe Hypertension, Seizures, and Confusion

from Section 7 - Postpartum

Published online by Cambridge University Press: 08 April 2025

Mokerrum Fatima Malik

Edited by

Peter F. Schnatz ,

D. Yvette LaCoursiere ,

Christopher M. Morosky ,

Jonathan Schaffir ,

Vanessa Torbenson and

David Chelmow

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Peter F. Schnatz: Affiliation:
The Reading Hospital, Pennsylvania
D. Yvette LaCoursiere: Affiliation:
University of California, San Diego
Christopher M. Morosky: Affiliation:
University of Connecticut School of Medicine
Jonathan Schaffir: Affiliation:
The Ohio State University College of Medicine
Vanessa Torbenson: Affiliation:
Mayo Clinic Alix School of Medicine
David Chelmow: Affiliation:
Virginia Commonwealth School of Medicine

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Summary

We discuss the case of a postpartum patient that develops posterior reversible encephalopathy syndrome (PRES) as characterized by clinical and neuro-radiological findings. It is described as an acute or subacute syndrome that presents with elevated blood pressure and symptoms of headache, altered mental status, seizures, and vision changes. Diagnosis of PRES is made with neuroimaging, with magnetic resonance imaging being the preferred modality. Pathognomonic imaging includes findings of posterior encephalopathy. There is a strong correlation of PRES in patients with preeclampsia and eclampsia. The syndrome can be reversed with timely and aggressive control of symptoms and underlying causes, which in this case included blood pressure control as well as seizure prophylaxis.

Keywords

postpartum posterior reversible encephalopathy syndrome PRES MRI cerebral imaging eclampsia preeclampsia

Type: Chapter
Information: Pregnancy Complications
A Case-Based Approach
, pp. 224 - 228

DOI: https://doi.org/10.1017/9781009413787.075 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2025

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References

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