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Medicina crítica (Colegio Mexicano de Medicina Crítica)

Print version ISSN 2448-8909

Abstract

GALVAN GASTELUM, Miguel Ángel; RAMIREZ CAMPANA, Jesús Cleofas; ARRAMBI DIAZ, Cibeles  and  MORALES BARRAZA, Jesús Ariel. Posterior Reversible Encephalopathy Syndrome. Atypical radiological presentation. Med. crít. (Col. Mex. Med. Crít.) [online]. 2020, vol.34, n.2, pp.160-163.  Epub Aug 08, 2022. ISSN 2448-8909.  https://doi.org/10.35366/93971.

Introduction:

Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical entity characterized by headache, visual disturbances and convulsive seizures. It is a sub-diagnosed entity that, due to its trigger being cerebral vasoregulation disorders, may present in pregnant women, which may be confused with eclampsia.

Clinical case:

Patient of 20 years of age, without pathological antecedents, with term pregnancy, evolutionary norm. Who enters by exit of mucous plug, followed by premature rupture of membranes, so it is admitted for conduction of labor, however presents convulsive crisis, generalized clonic tonic. Advanced airway management is decided, and an emergency caesarean section is performed, obtaining a single live product, and the patient is admitted to the ICU. His toxemic profile was reported without alterations, his initial CT scan without structural alterations, and mechanical ventilation was removed twelve hours later. MRI is performed where subcortical right parieto-occipital hyperintensity is observed, being kept under surveillance and graduated to floor without complications.

Conclusions:

The treatment of PRES syndrome is focused on organic and metabolic supports and mainly on tension Figures. Not all are reversible, however, the pregnant patient is more frequent than present evolution without sequelae. Magnetic resonance is the study of choice for this clinical entity, and the typical findings are symmetrical edema of white matter in the posterior cerebral hemispheres, particularly the parieto-occipital regions, but there are variations.

Keywords : Pregnancy; encephalopathy; eclampsia; Posterior Reversible Encephalopathy Syndrome (PRES); MRI monitoring.

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