Posterior reversible encephalopathy syndrome in a patient with superimposed preeclampsia – a case report

Objective: Posterior reversible encephalopathy syndrome (PRES) is a rare and not always reversible neurological complication associated with pre-eclampsia.

Methods: Here, we report a case of a 40-year-old multipara with idiopathic pre-pregnancy hypertension, an acute crisis of elevated blood pressure, neurological deficits and high grade protein urine excretion at 30 weeks of gestation. The MRI showed hyperintense signal alterations in the central region and periventricular in both hemispheres in a T2 weighted sequence consistent with the radiological diagnosis of a posterior reversible encephalopathy syndrome. Due to uncontrollable hypertension and pathological cardiotocography an emergency Caesarean section was carried out.

Results: On the first day postpartum neurological and hypertensive symptoms had completely dissolved.

Conclusion: With appropriate therapy, the prognosis of PRES is excellent, hence a clinician should be aware of this syndrome. Delayed diagnosis can cause permanent brain injury.