26405496 Visualization

A woman Sex aged Age 31 Age years Age , G2P2 History , without History any History pathological History past History history History , with good History prenatal History care History , with a normal Family_history prenatal Diagnostic_procedure analysis Diagnostic_procedure , blood Diagnostic_procedure pressure Diagnostic_procedure during the follow Clinical_event - up Clinical_event was normal Lab_value , admitted for elective caesarian Therapeutic_procedure section Therapeutic_procedure at 38 Duration weeks Duration of amenorrhea Sign_symptom .
During realization of the spinal Biological_structure anesthesia Therapeutic_procedure the patient presented peak of the hypertensive Sign_symptom ( 180/100 Lab_value mm Lab_value Hg Lab_value ) which normalized Lab_value after Time a Time few Time minutes Time without treatment Therapeutic_procedure .
In post Clinical_event - partum Clinical_event , after Time 12 Time hours Time of the caesarian section the lady presented a severe Severity headache Sign_symptom with apyrexia Sign_symptom then she developed three Detailed_description episodes Detailed_description of generalized Detailed_description tonico Detailed_description - clonic Detailed_description convulsions Sign_symptom .
The 1st Detailed_description convulsion Sign_symptom ceased 1 Time min Time after Time the measures of resuscitation Therapeutic_procedure and injection Administration of diazepam Medication IV Medication .
The post-critical clinical Diagnostic_procedure examination Diagnostic_procedure found an afebrile Sign_symptom patient and blood Diagnostic_procedure pressure Diagnostic_procedure at 140/90 Lab_value mmHg Lab_value and with Glasgow Diagnostic_procedure coma Diagnostic_procedure scale Diagnostic_procedure at 14 Lab_value without any neurological Sign_symptom deficit Sign_symptom , there was no neck Biological_structure rigidity Sign_symptom , diuresis Sign_symptom was preserved.
The examination Diagnostic_procedure of Diagnostic_procedure urines Diagnostic_procedure by urinary Detailed_description strip Detailed_description was positive Lab_value (+ + +).
The 2nd Detailed_description and Detailed_description 3th Detailed_description convulsive Sign_symptom crisis Sign_symptom stoped spontaneously within Time few Time seconds Time .
Laboratory Diagnostic_procedure findings Diagnostic_procedure of HELLP Disease_disorder syndrome Disease_disorder include raised Lab_value liver Diagnostic_procedure enzymes Diagnostic_procedure ( ASAT Diagnostic_procedure 525 Lab_value IU/L Lab_value and ALAT Diagnostic_procedure 214 Lab_value IU/L Lab_value ), hemolysis Sign_symptom ( hemoglobinemia Sign_symptom in 7 Lab_value mg/dl Lab_value ) and low Lab_value platelet Diagnostic_procedure count Diagnostic_procedure ( 44 Lab_value 000 Lab_value platelet/mL Lab_value ).
Other investigations included the renal Diagnostic_procedure function Diagnostic_procedure tests Diagnostic_procedure , the inflammatory Diagnostic_procedure markers Diagnostic_procedure , the thyroid Diagnostic_procedure hormones Diagnostic_procedure were normal Lab_value .
The viral Diagnostic_procedure serology Diagnostic_procedure was negative Lab_value .
The patient was transferred Clinical_event to intensive Nonbiological_location care Nonbiological_location unit Nonbiological_location ; she was treated immediately by magnesium Medication sulfate Medication associated to calcium Medication channel Medication blocker Medication ( nicardipine Medication ), antiepileptic Medication ( phenobarbital Medication ) and preventive dose of low Detailed_description molecular Detailed_description weight Detailed_description heparin Medication .
The anemia Sign_symptom and thrombopenia Sign_symptom corrected by transfusion Therapeutic_procedure of packed Medication red Medication blood Medication cells Medication and platelet Medication respectively.
The magnetic Diagnostic_procedure resonance Diagnostic_procedure imaging Diagnostic_procedure ( MRI Diagnostic_procedure ), realized one Time hour Time after Time the first episode of convulsion showed zones Sign_symptom in hyposignal Diagnostic_procedure T1 Diagnostic_procedure , hypersignal Diagnostic_procedure T2 Diagnostic_procedure and flair Diagnostic_procedure sequences Diagnostic_procedure , interesting the cerebral Biological_structure cortex Biological_structure , parietal Biological_structure and occipital Biological_structure sub Biological_structure - cortical Biological_structure and the white Biological_structure matter Biological_structure .
Intracranial Biological_structure venous Biological_structure sinuses Biological_structure were permeable Sign_symptom .
The diagnosis of the PRES Disease_disorder syndrome Disease_disorder secondary to the severe Severity preeclampsia Disease_disorder immediate post-partum was retained (Figure 1).
The electroencephalogram Diagnostic_procedure ( EEG Diagnostic_procedure ) realized in Date the Date second Date day Date did not showed anomaly Sign_symptom .
The evolution was marked by the normalization Lab_value of blood Diagnostic_procedure pressure Diagnostic_procedure , the normalization Lab_value of the neurological Diagnostic_procedure state Diagnostic_procedure and of the biological Diagnostic_procedure analysis Diagnostic_procedure .
The patient discharged Clinical_event in good Lab_value condition Diagnostic_procedure on day Date 5 Date , with beta Medication - blocker Medication and sodium Medication valproate Medication maintained during three Duration months Duration .
THE MRI Diagnostic_procedure of the controle made three Date months Date later Date showed complete resolution of cerebral Biological_structure edema Sign_symptom Figure 2.