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HELLP syndrome with haemaglobin vasospasm.

J Gliemroth1, U Knopp, U Kehler

  • 1Department of Neurosurgery, Medical University of Lübeck, Germany.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|June 10, 2000
PubMed
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HELLP syndrome, a severe pre-eclampsia complication, can cause intracerebral hemorrhage. Cerebral vasospasm is a critical, potentially fatal, complication requiring careful patient monitoring.

Area of Science:

  • Obstetrics and Gynecology
  • Neurology
  • Critical Care Medicine

Background:

  • HELLP syndrome (haemolysis, elevated liver enzymes, low platelets) is a severe, life-threatening complication of pre-eclampsia.
  • Intracerebral hemorrhage is a rare but devastating initial presentation of HELLP syndrome.

Observation:

  • A 36-year-old woman presented with HELLP syndrome complicated by intracerebral hemorrhage.
  • Diagnosis was confirmed by characteristic laboratory findings: elevated liver enzymes, low platelets, increased bilirubin, and lactate dehydrogenase.
  • Following surgical evacuation of the hematoma, the patient developed cerebral vasospasm on day 11, confirmed by angiography and CT.

Findings:

  • Despite initial neurological recovery after hematoma removal, the patient succumbed to cerebral edema.

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  • Cerebral vasospasm emerged as a significant secondary complication, contributing to the fatal outcome.

    • Implications:

    • This case highlights the critical importance of considering and monitoring for cerebral vasospasm in patients with HELLP syndrome.
    • Early recognition and management of vasospasm may be crucial for improving outcomes in these high-risk patients.