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Multifocal cerebral hemorrhage in eclampsia and severe pre-eclampsia
1Department of Neurology, Beth Israel Hospital, Boston, MA 02215, USA.
Journal of Neurology
|March 1, 1997
Summary
Eclampsia and severe pre-eclampsia can cause serious brain hemorrhages, not just temporary vision loss. These multifocal hemorrhages, particularly in the posterior brain, may lead to lasting cognitive deficits.
Area of Science:
- Neurology
- Radiology
- Obstetrics
Background:
- Eclampsia and severe pre-eclampsia are often linked to transient cortical blindness and posterior brain imaging abnormalities.
- While petechial hemorrhages have been noted, major cerebral hemorrhages are considered infrequent.
Observation:
- This study reviewed four patients with eclampsia or severe pre-eclampsia presenting with acute, multifocal cerebral hemorrhages on CT.
- Hemorrhages were predominantly bilateral and located in posterior brain regions.
- Two patients had normal scans prior to the hemorrhage detection, and one patient died.
Findings:
- Contrary to previous assumptions, posterior CT and MRI abnormalities in eclampsia/severe pre-eclampsia may include multifocal hemorrhages.
- These hemorrhages can be associated with significant, long-term neurologic complications, including cognitive deficits.
Implications:
- The findings challenge the notion that radiologic changes in eclampsia are always benign and reversible.
- There is an increased vulnerability of the posterior circulation to the hypertensive vascular disease associated with eclampsia, potentially leading to severe outcomes.