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Updated: Feb 9, 2026

The Hypoxic Ischemic Encephalopathy Model of Perinatal Ischemia
Published on: November 19, 2008
An Unusual Case of Posterior Reversible Encephalopathy Syndrome
Robert P Zemple1, Tomer Pelleg2, Moises R Cossio3
1Carilion Clinic, Department of Emergency Medicine, Roanoke, Virginia.
Abstract:
A 21-year-old pregnant female with no significant past medical history presented with acute onset headache and nausea as well as tonic-clonic seizures, then rapidly decompensated into a coma with complete absence of brainstem reflexes. The patient was ultimately diagnosed with hemolysis, elevated liver enzymes, and low platelets (HELLP syndrome) and subsequent posterior reversible encephalopathy syndrome (PRES) with brainstem involvement. Emergent delivery and blood pressure control resulted in rapid and complete neurologic recovery.
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