Posterior Reversible Encephalopathy Syndrome in the Late Postpartum Period: A Case Report

• Published in: Türk nöroloji dergisi 2018-01, Vol.24 (4), p.340-341
• Main Authors: Çakar, Merve Melodi, Kehaya, Sezgin, Özkan, Hülya, Güldiken, Babürhan Feyzullah
• Format: Article
• Language: English
• Subjects: ataxia; eclampsia; magnetic resonance imaging; Posterior reversible encephalopathy syndrome; Tıp
• ISSN: 1301-062X; 1309-2545
• DOI: 10.4274/tnd.65481

A 27-year-old female patient was admitted to the emergency department with symptoms of severe headache, blurred vision, and imbalance. From her past medical history, it was learned that she gave birth to her second baby by cesarean section one week before, her headache started on the second postnatal day along with nausea and vomiting, and that her systolic blood pressure was measured as 190 mmHg during this period. Her arterial blood pressure was 155/90 mmHg in the emergency department. Other systemic examination findings were normal. A neurologic examination revealed no pathologic findings except truncal ataxia, and the fundus examination was normal. Computed tomography of the patient revealed narrowed cerebral sulci and compressed ventricles. Diffuse cortical hyperintensity was observed in the cerebellar vermis, bilateral parietooccipital, frontal and temporal regions on FLAIR-weighted magnetic resonance imaging (MRI) (Figure 1). Cranial MR venography demonstrated patent venous structures. The patient was hospitalized with a diagnosis of posterior reversible encephalopathy syndrome (PRES) and amlodipine 5 mg/day was initiated for her high blood pressure. Proteinuria was detected (urine total protein 503.64 mg/day; normal