Posterior reversible encephalopathy syndrome in the puerperium
Keywords:
encephalopathy, magnetic resonance imaging, puerperiumAbstract
Introduction: Posterior reversible encephalopathy syndrome is a transient clinical-radiological disorder that can occur in pregnant or postpartum women. Its incidence and prevalence are unknown due to the transient course of the clinical picture and the limitations of imaging studies in this population.
Objective: To describe the characteristics and clinical course of a postpartum woman diagnosed with posterior reversible encephalopathy syndrome.
Clinical case: A 36-year-old postpartum woman with a history of bronchial asthma and a previous cesarean section developed elevated blood pressure and headache 24 hours after surgery. She later presented with vision loss and tonic-clonic seizures, impaired consciousness, and respiratory depression, necessitating mechanical ventilation. A simple cranial computed tomography and magnetic resonance imaging (MRI) were performed; reversible posterior encephalopathy was diagnosed. With intensive treatment, the patient progressed favorably until discharge.
Conclusions: Posterior reversible encephalopathy syndrome is an underdiagnosed disease that should be considered when seizures, persistent headache, and vision loss occur in patients with severe hypertensive disease of pregnancy or in the early postpartum period.
Downloads
References
1. Tortajada Soler J, Tauler Redondo MP, Garví López M, Lozano Serrano MB, López-Torres López J, Sánchez López M. Síndrome de encefalopatía posterior reversible en pacientes críticos COVID-19: reporte de 2 casos [Internet]. Rev Esp Anestesiol Reanim. 2021 [acceso: 17/06/2024]; 70(1):51-5. Disponible en: https://pmc.ncbi.nlm.nih.gov/articles/PMC8321770/
2. Sadamoto Y. A Case of Reversible Posterior Leukoencephalopathy Syndrome (PRES) With a History of Migraine and Onset With Initial Visual Aura and Migraine-Like Headache, With a Significant Response to Lasmiditan: A Case Report [Internet]. Cureus. 2023; 15(11):e49311. DOI: 10.7759/cureus.493112
3. Moret Rueda M, Torres Jiménez W. Síndrome de encefalopatía posterior reversible en un paciente con hyper-CVAD. Reporte de un caso [Internet]. Medicina Clínica Práctica. 2022 [acceso: 17/09/2024]; 5(3):[aprox. 6p]. Disponible en: https://www.sciencedirect.com/science/article/pii/S2603924922000088
4. Álvarez Y, Beltrán M, Di Lizio KG. Síndrome de encefalopatía posterior reversible, eclampsia y síndrome de Hellp [Internet]. Rev chil obstet ginecol. 2017 [acceso: 17/09/2024]; 82(3):[aprox. 10p]. Disponible en: https://elo.conicyt.cl/scielo.php?script=sci_arttext&pid=S0717-75262017000300280
5. Carrillo ER, Echevarría KJ, De los Ríos TA, Reyes ML. Síndrome de encefalopatía reversible posterior [Internet]. Med Int Mex. 2013 [acceso: 17/06/2024]; 29(3):299-306. Disponible en: https://www.medigraphic.com/pdfs/medintmex/mim-2013/mim133j.pdf
6. Galván Gastélum M, Ramírez Campaña J, Arrambí Díaz C, Morales Barraza JA. Síndrome de encefalopatía posterior reversible. Presentación radiológica atípica [Internet]. Col Mex Med Crít. 2020 [acceso: 19/10/2024]; 34(2):160-3. Disponible en: http://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S2448-89092020000200160&lng=es
7. Algarín Lara H, Arciniegas Vergel Y, Solano Ropero J, Patiño Patiño Y, E Salas Danies, Osorio Rodríguez E. Síndrome de encefalopatía posterior reversible asociado a síndrome HELLP durante el puerperio inmediato [Internet]. Acta Colombiana de Cuidado Intensivo. 2022 [acceso: 19/10/2024]; 22(4):356-60. Disponible en: https://www.elsevier.es/es-revista-acta-colombiana-cuidado-intensivo-101-articulo-sindrome-encefalopatia-posterior-reversible-asociado-S0122726222000027
8. Bakkali S, Barrio Fernández P, Martínez Cortés L, Huertas Fernández MA. Síndrome de encefalopatía posterior reversible durante el puerperio [Internet]. Prog Obstet Ginecol. 2017 [acceso: 19/01/2025]; 60(4):380-4. Disponible en: https://sego.es/documentos/progresos/v60-2017/n4/15_POG_S_14_00181_1_1_sindrome_encefalopatia.pdf
9. Villafuerte Delgado D, Pérez Martínez E, González Pérez F. Síndrome de encefalopatía reversible posterior. Presentación de un caso y revisión de la literatura [Internet]. Revista Finlay. 2019 [acceso: 01/04/2024]; 9(4):e752. Disponible en: https://revfinlay.sld.cu/index.php/finlay/article/view/752
10. Fonseca J, Oliveira K, Cordeiro M, Real MV. Posterior reversible encephalopathy syndrome: A case report [Internet]. Neurología. 2019; 34(2):135-7. DOI: 10.1016/j.nrl.2016.07.011
11. Tetsuka S, Ogawa T. Posterior reversible encephalopathy syndrome: A review with emphasis on neuroimaging characteristics [Internet]. Journal of the Neurological Sciencie. 2019 [acceso: 11/10/2024]; 404:72-5. Disponible en: https://www.jns-journal.com/article/S0022-510X(19)30321
12. Castrillo A, Mendoza Rodríguez R, Gutiérrez Ríos MI, Zamora N, Morollón MF, Rodríguez Sanz J. Encefalopatía posterior reversible en un caso de eclampsia tardía [Internet]. Rev Neurl. 2023 [acceso: 11/10/2024]; 57:112-7. Disponible en: https://neurologia.com/articulo/2013040
13. de la Torre-León T, Miranda-Contreras A, Gómez-Secundino M, Nava-López JA, de la Torre-León MA, de la Luna y Olsen EA. Encefalopatía posterior reversible durante el puerperio, secundaria a eclampsia. Reporte de dos casos [Internet]. Ginecol Obstet Mex. 2018; 86(12):815-22. DOI: 10.24245/gom. v86i12.2343
14. Osorio Rodríguez EL, García Perlaza C, Navarro Devia A, Salas Danies E, Pineda Tovar M, Guevara Romero E. Síndrome de encefalopatía posterior reversible secundario a trastornos hipertensivos del embarazo. Serie de casos [Internet]. Ginecol obstet Méx. 2021 [acceso: 11/10/2024]; 89(10):770-8. Disponible en: https://www.scielo.org.mx/scielo.php?script=sci_arttext&pid=S0300-90412021001000770
15. Liman TG, Siebert E, Endres M. Posterior reversible encephalopathy síndrome [Internet]. Curr Opin Neurol. 2019 [acceso: 10/10/2024]; 32(1):25-35. Disponible en: https://pubmed.ncbi.nlm.nih.gov/30531559/
16. Konar H, Agarwal L, Priyanka P, Chaudhuri S. Posterior reversible encephalopathy síndrome in women whit eclampsia: reporto of three cases [Internet]. J Obstet Gynecol India. 2021; 71(3):318-21. DOI: 10.1007/s10072-019-1
17. Villamar Macias L, Bajaña Quinto M, Pinos Calle J, Manzano Altamirano J. Síndrome de encefalopatía posterior reversible en el postparto. Estudio de caso [Internet]. Rev Cienc Salud. 2020 [acceso: 10/01/2025]; 2(3):57-62. Disponible en: https://acvenisproh.com/revistas/index.php/masvita/article/wiew/158/473
Published
How to Cite
Issue
Section
License
Copyright (c) 2025 Enrique Reyes Guerrero, Sara Amneris Urgellés Carreras, Yoani Batan Bermúdez, Deborah Rodríguez Verdecie, Daniellis Arguelles Soria, Rubén Peña Ruiz
This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.
Authors who have publications with this Journal accept the following terms:
- The authors will retain their copyright and guarantee the Journal the right of first publication of their work, which will simultaneously be subject to the Creative Commons Attribution License. The content presented here can be shared, copied and redistributed in any medium or format; Can be adapted, remixed, transformed or created from the material, using the following terms: Attribution (giving appropriate credit to the work, providing a link to the license, and indicating if changes have been made); non-commercial (you cannot use the material for commercial purposes) and share-alike (if you remix, transform or create new material from this work, you can distribute your contribution as long as you use the same license as the original work).
- The authors may adopt other non-exclusive license agreements for the distribution of the published version of the work (for example: depositing it in an institutional electronic archive or publishing it in a monographic volume) as long as the initial publication in this Journal is indicated.
- Authors are allowed and recommended to disseminate their work through the Internet (e.g., in institutional electronic archives or on their website) before and during the submission process, which can produce interesting exchanges and increase citations. of the published work.
