Posterior Reversible Encephalopathy Syndrome after Cesarean Section under Spinal Anesthesia: A case report.
10.4097/kjae.2007.52.6.S86
- Author:
Jeong Yeon HONG
1
;
Young Suck JEE
;
In Ho LEE
;
Joong Sik SHIN
;
Hyuk Joong CHOI
Author Information
1. Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Severance Hospital, Yonsei University College of Medicine, Korea. jenyhongg@naver.com
- Publication Type:Case Report
- Keywords:
posterior reversible encephalopathy syndrome;
postpartum
- MeSH:
Adult;
Anesthesia, Spinal*;
Blood Pressure;
Brain;
Cesarean Section*;
Diagnosis;
Edema;
Female;
Headache;
Hemianopsia;
Humans;
Magnesium Sulfate;
Magnetic Resonance Imaging;
Neurologic Manifestations;
Post-Dural Puncture Headache;
Posterior Leukoencephalopathy Syndrome*;
Postpartum Period;
Pregnancy;
Proteinuria;
Rabeprazole;
Seizures;
Valproic Acid
- From:Korean Journal of Anesthesiology
2007;52(6):S86-S90
- CountryRepublic of Korea
- Language:English
-
Abstract:
A posterior reversible encephalopathy syndrome (PRES) is characterized as headache, altered mental function, seizure, and visual disturbances resulted from vasogenic edema in the brain. A 29-year-old normotensive parturient developed a postural headache two days after the cesarean section under spinal anesthesia. The headache was initially misdiagnosed as a postdural puncture headache (PDPH). The patient experienced generalized seizures four days after delivery. Her blood pressure increased to 170/100 mmHg with mild proteinuria. She developed homonymous hemianopsia two days after the seizures. MRI revealed high signal intensity areas in the posterior temporal, frontal, occipital and parietal white matter. Presuming a diagnosis of PRES, the patient was treated with magnesium sulfate, sodium valproate, and carbohydrate solutions. She was discharged without headache or neurologic deficit on postoperative day 13. When patients present a headache with focal neurological deficits or visual disturbances, the anesthesiologist must consider the possibility of PRES and aggressively treat based on the clinical presentation.
