Posterior Reversible Encephalopathy Syndrome in a Postpartum Patient With Eclampsia

Posterior reversible encephalopathy syndrome (PRES) is a neurological emergency commonly associated with hypertensive disorders of pregnancy, particularly preeclampsia and eclampsia. It is characterized by vasogenic edema predominantly affecting the parieto-occipital regions of the brain and may present with seizures, visual disturbances, altered mental status, and severe headache. Early recognition and prompt management are essential to prevent permanent complications. We report the case of a 30-year-old postpartum woman with pregnancy-induced hypertension complicated by eclampsia who developed severe headache, blurred vision, and recurrent generalized tonic-clonic seizures following a cesarean section delivery at 37 weeks and 5 days of gestation. Computed tomography (CT) of the brain demonstrated bilateral parieto-occipital hypoattenuation with additional involvement of the caudate nuclei and posterior external capsules. The radiological impression was that the findings were consistent with PRES. The patient was managed with antihypertensive therapy, magnesium sulfate, anticonvulsants, ventilatory support, and intensive care monitoring, resulting in gradual clinical neurological improvement. This case highlights the diagnostic challenge posed by an atypical and relatively extensive distribution of CT abnormalities in postpartum eclampsia, particularly when MRI and follow-up neuroimaging are unavailable for definitive lesion characterization and confirmation of radiological reversibility.