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Posterior reversible encephalopathy syndrome: a case study.

Jane Fitzgerald-Hines1, Mary L King

  • 1Neuroscience Intensive Care Unit at Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA. jane.fitzgerald-hines@chw.edu

The Journal of Neuroscience Nursing : Journal of the American Association of Neuroscience Nurses
|October 31, 2006
PubMed
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A postpartum woman experienced seizures and coma due to posterior reversible encephalopathy syndrome (PRES), linked to preeclampsia and hypertension. Prompt diagnosis and multidisciplinary care led to a positive outcome.

Area of Science:

  • Neurology
  • Obstetrics
  • Critical Care Medicine

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition characterized by headache, seizures, and altered mental status.
  • Preeclampsia, a hypertensive disorder of pregnancy, is a known risk factor for PRES.
  • Postpartum women are susceptible to PRES, necessitating vigilant monitoring.

Observation:

  • A young woman, 4 days postpartum, presented with seizures and fluctuating mentation, progressing to unresponsiveness.
  • Computed tomography revealed significant white-matter edema, indicating cerebral involvement.
  • The patient's condition deteriorated into a coma, unresponsive to interventions for intracranial pressure.

Findings:

  • The final diagnosis was posterior reversible encephalopathy syndrome (PRES).

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  • The PRES was directly related to a preeclamptic condition and associated hypertension.
  • Multidisciplinary collaboration between obstetrics, neurology, and neuroscience nursing was crucial.

    • Implications:

    • This case highlights the importance of recognizing PRES in postpartum women with preeclampsia.
    • Effective management requires a collaborative approach involving various medical specialties.
    • Vigilant nursing care is essential for positive patient outcomes in complex neurological cases.