Reversible non enhancing lesions without focal neurological deficits in eclampsia

Nine patients with eclampsia, were subjected to computerized tomographic scan (CT scan) of the head to ascertain the changes in the brain that accompany seizures and encephalopathy of eclampsia. Only those patients who had a seizure within the past 24 h were included in this study. None of the patients had any focal neurological deficit. Six of the nine patients had abnormal findings on CT scan consisting of multiple non enhancing hypodensities in the cerebral white matter. One patient also had subependymal haemorrhage over the lateral ventricle. These changes were found to have disappeared when the CT scan was repeated on the seventh day. There was no correlation between the mean arterial blood pressure or the number of seizures and the presence of hypodensities in the brain. These findings suggest that subclinical changes in the form of reversible hypodensities and rarely bleeding can occur in eclampsia even when patients have no focal neurological deficits. It appears that these lesions represent focal areas of cerebral oedema, secondary to failure of autoregulation of cerebral blood flow.