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Multiple brain infarcts associated with severe preeclampsia.

V L Schimp1, M Hallak, K S Puder

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Severe preeclampsia can cause brain infarcts in the occipital and parietal lobes, as seen on CT and MRI scans. These lesions, though initially severe, resolved completely postpartum in a unique case report.

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Area of Science:

  • Neurology
  • Radiology
  • Obstetrics

Background:

  • Eclampsia is a severe complication of pregnancy characterized by seizures.
  • Posterior circulation cerebral edema and infarcts have been linked to eclampsia.
  • Neuroimaging findings in eclampsia can be varied and require detailed analysis.

Purpose of the Study:

  • To report a unique case of severe preeclampsia with significant brain imaging findings.
  • To illustrate the neuroimaging characteristics of posterior circulation lesions in eclampsia.
  • To document the resolution of these brain lesions after delivery.

Main Methods:

  • Computed tomography (CT) scan and magnetic resonance imaging (MRI) were utilized for brain imaging.
  • Serial imaging was performed during pregnancy and postpartum.
  • Clinical assessment of neurologic deficits was correlated with imaging findings.

Main Results:

  • CT scan revealed gray-white matter infarct-like lesions in the basal ganglia and parieto-occipital lobes in a patient at 26 weeks gestation with severe preeclampsia.
  • MRI confirmed similar abnormalities postpartum, despite clinical symptom resolution.
  • Repeat CT scan at 6 weeks postpartum showed complete resolution of all infarcts.

Conclusions:

  • Severe preeclampsia can manifest with significant and extensive posterior brain infarcts.
  • Neuroimaging findings in eclampsia can be dramatic but may show complete resolution postpartum.
  • This case highlights the importance of neuroimaging in diagnosing and monitoring eclamptic complications.