Clinical and radiologic features of posterior reversible encephalopathy syndrome associated with preeclampsia-eclampsia

Abstract

Objective To investigate the clinical and radiologic features of posterior reversible encephalopathy syndrome (PRES) associated with preeclampsia-eclampsia. Methods Twenty-one cases of PRES associated with preeclampsia-eclampsia were retrospectively studied on some aspects of clinical and radiologic features. Results The most common clinical presentations were seizures（18 cases）, headache （16 cases）, altered mentation (15 cases) and vision change (12 cases). Vasogenic edema lesions distributed in the parietal or occipital lobe (20 cases), the frontal lobes (14 cases), temporal lobes (11 cases), and basal ganglia (11 cases). The splenium involvement occurred in 4 cases，cerebellar hemispheres and brain stem involvement was presented in 3 cases and 1 case separately. Three major patterns of PRES included dominant parietal-occipital (7 cases)，the holohemispheric watershed (7 cases), and superior frontal sulcal (6 cases). Partial and asymmetric expression of PRES only occurred in 1 case. Conclusions The clinical features of PRES associated with preeclampsia-eclampsia are typical. Except the parietal or occipital lobe, involvement of the frontal lobe, temporal lobe and basal ganglia is common, followed by the occasional presence of the splenium, cerebellar hemispheres and brain stem. Three primary PRES patterns are noted, occasional with partial and asymmetric expression of PRES. Awareness of these typical and variable characteristics is important to recognize the PRES neurotoxicity more accurately when PRES present. Key words: Pre-eclampsia; Eclampsia; Posterior leukoencephalopathy syndrome; Brain edema; Magnetic resonance imaging