Open AccessPosterior reversible encephalopathy syndrome at term pregnancy
Author(s) -
Shreepathi Krishna Achar,
Smiti Nanda,
Tim Thomas Joseph
Publication year - 2011
Publication title -
indian journal of anaesthesia/indian journal of anaesthesia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.645
H-Index - 30
eISSN - 0976-2817
pISSN - 0019-5049
DOI - 10.4103/0019-5049.84856
Subject(s) - medicine , posterior reversible encephalopathy syndrome , white matter , pregnancy , cortical blindness , occipital lobe , encephalopathy , anesthesia , pediatrics , blindness , magnetic resonance imaging , radiology , genetics , biology , optometry
Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological syndrome associated with various clinical conditions, presenting with headache, encephalopathy, seizures, cortical visual disturbances or blindness. Imaging predominantly shows parieto-occipital white matter changes, with vasogenic oedema being the most accepted pathophysiology. We report a 25-year-old primigravida who presented in term pregnancy with seizures and blindness, scheduled for emergency caesarean section. She was managed peroperatively under general anaesthesia and shifted to intensive care unit. Postoperative computed tomography brain revealed an intra-axial hypodensity involving predominantly white matter regions of bilateral parieto-occipital lobes, right caudate nucleus and right cerebellum, suggestive of PRES. Clinical improvement with complete resolution of visual disturbances was observed with supportive treatment. The importance of prompt suspicion and management in preventing short- and long-term neurological deficits in reversible condition like PRES is highlighted.