Eight cases of pregnancy-related posterior reversible encephalopathy syndrome diagnosed with magnetic resonance imaging

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  • NISHIBATA Shuhei
    Department of Obstetrics and Gynecology, Kansai Medical University
  • YOSHIDA Aya
    Department of Obstetrics and Gynecology, Kansai Medical University
  • SOEJIMA Chikako
    Department of Obstetrics and Gynecology, Kansai Medical University
  • YASUHARA Yuki
    Department of Obstetrics and Gynecology, Kansai Medical University
  • KAMIYA Akio
    Department of Obstetrics and Gynecology, Kansai Medical University
  • KURODA Yumi
    Department of Obstetrics and Gynecology, Kansai Medical University
  • TORI Ayumi
    Department of Obstetrics and Gynecology, Kansai Medical University
  • OKADA Hidetaka
    Department of Obstetrics and Gynecology, Kansai Medical University

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  • MRI検査で診断したposterior reversible encephalopathy syndrome（PRES）妊産婦8例の検討
  • MRI ケンサ デ シンダン シタ posterior reversible encephalopathy syndrome (PRES)ニンサンプ 8レイ ノ ケントウ

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Abstract

<p>Posterior reversible encephalopathy syndrome (PRES) is cerebral vasogenic edema induced by vascular endothelial cell dysfunction and usually shows reversible neurological symptoms and changes in the posterior area of the brain. Preeclampsia and eclampsia can induce pregnancy-related PRES. Optimal reduction in blood pressure may prevent the progression of vasogenic edema to cytotoxic edema. Therefore, failure to treat the hypertension promptly may cause intracranial hemorrhage, permanent neurological deficits, and death. Among the patients with neurological symptoms (headache, visual disturbance, confusion, seizure, vomiting, etc.) reported from 2007 to 2017 in our institution, we identified eight patients who were diagnosed with PRES by brain magnetic resonance imaging (MRI). Eclampsia was present in five patients, whereas all patients had hypertension. With the exception of one patient who had intracranial hemorrhage, and therefore, experienced persistent mild higher brain dysfunction, all other patients had good prognosis.In six out of eihgt patients, follow-up MRI was obtained after four to 27 days, which showed complete resolution. Initial MRI should be performed as soon as possible from the onset of neurological symptoms,because of its effectiveness in predicting prognosis.Early diagnosis of PRES enables early treatment and good prognosis. [Adv Obstet Gynecol, 72 (3) : 237-242, 2020 (R2.8)]</p>

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