Wang Y, Zhang Q. Postpartum posterior reversible encephalopathy syndrome secondary to preeclampsia and cerebrospinal fluid leakage: A case report and literature review. World J Clin Cases 2022; 10(28): 10332-10338 [PMID: 36246802 DOI: 10.12998/wjcc.v10.i28.10332]
Corresponding Author of This Article
Qing Zhang, MMed, Attending Doctor, Department of Anesthesiology, Zhabei Central Hospital, No. 619 Zhonghuaxin Road, Shanghai 200071, China. 13701989836@163.com
Research Domain of This Article
Obstetrics & Gynecology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Clin Cases. Oct 6, 2022; 10(28): 10332-10338 Published online Oct 6, 2022. 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
Yu Wang, Qing Zhang
Yu Wang, Qing Zhang, Department of Anesthesiology, Zhabei Central Hospital, Shanghai 200071, China
Author contributions: Wang Y and Zhang Q attended to the patient and drafted the manuscript; Both authors read and approved the final version of the manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Qing Zhang, MMed, Attending Doctor, Department of Anesthesiology, Zhabei Central Hospital, No. 619 Zhonghuaxin Road, Shanghai 200071, China. 13701989836@163.com
Received: June 7, 2022 Peer-review started: June 7, 2022 First decision: June 16, 2022 Revised: July 28, 2022 Accepted: August 25, 2022 Article in press: August 25, 2022 Published online: October 6, 2022 Processing time: 112 Days and 9.3 Hours
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.
Core Tip: Posterior reversible encephalopathy syndrome (PRES) is often associated with hypertension and eclampsia. Here, we report a case of postpartum PRES secondary to preeclampsia and intracranial hypotension caused by dural puncture and cerebrospinal fluid leakage. This case highlights the risk of PRES in laboring women with intracranial hypotension secondary to cerebrospinal fluid leakage and hypertension caused by intraspinal anesthesia.
