Postpartum posterior reversible encephalopathy syndrome secondary to preeclampsia and cerebrospinal fluid leakage: A case report and literature review

Yu Wang; Qing Zhang

doi:10.12998/wjcc.v10.i28.10332

Postpartum posterior reversible encephalopathy syndrome secondary to preeclampsia and cerebrospinal fluid leakage: A case report and literature review

World J Clin Cases. 2022 Oct 6;10(28):10332-10338. doi: 10.12998/wjcc.v10.i28.10332.

Authors

Yu Wang¹, Qing Zhang²

Affiliations

¹ Department of Anesthesiology, Zhabei Central Hospital, Shanghai 200071, China.
² Department of Anesthesiology, Zhabei Central Hospital, Shanghai 200071, China. 13701989836@163.com.

Abstract

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.

Keywords: Case report; Crystalloid fluid; Dural puncture; Intracranial hypotension; Posterior reversible encephalopathy syndrome.

Publication types

Case Reports