[Circulatory disturbance of deep cerebral veins in eclampsia]

A case of eclampsia with interesting angiographic findings is reported. A 19-year-old woman in the 35th week of gestation by date was admitted due to a sudden onset of generalized clonic convulsion and disturbance of consciousness. The diagnosis was eclampsia. On the second hospital day, extraction of a stillborn female was performed by laminaria. Thereafter, the consciousness improved rapidly and she became alert on the following day. She was discharged without neurological deficit on the 18th hospital day. A CT scan on the day of admission showed narrow lateral ventricles and symmetrical low-density lesions in and around the basal ganglia. These had almost disappeared by the 10th hospital day. Carotid angiography on admission revealed no abnormality in the arterial phase including the lenticulostriate arteries, but, early appearance of deep cerebral veins and some cortical veins was noted. These deep veins, however, were not distinct even in the venous phase. These angiographic findings suggested medullary dilatation caused by circulatory disturbance of the deep cerebral veins. Most authors have stressed the contribution of diffuse arterial vasospasm in the pathogenesis of eclampsia in relation to low-density lesions on CT scans. In the present case, we could not find vasospasm but found circulatory disturbance of the deep cerebral veins. These angiographic findings suggested that the appearance of the low-density lesions on the CT scan was most likely due to venous congestion caused by circulatory disturbance of the deep cerebral veins, since most of the deep medullary veins in the low-density lesions flowed into the deep cerebral veins.(ABSTRACT TRUNCATED AT 250 WORDS)