Reversible posterior leukoencephalopathy syndrome in a postpartum woman without eclampsia.
We report a patient who developed reversible posterior leukoencephalopathy syndrome (RPLS) in puerperium without preeclampsia-eclampsia or chronic hypertension. The woman suddenly complained of visual loss and headache 10 days after delivery caused by edematous lesions mainly distributed in the bilateral occipital lobe. Apparent diffusion coefficient map was useful for distinction of this vasogenic edema from cytotoxic edema due to brain infarction. Under the diagnosis of RPLS, we successfully treated her disease using a trinitroglycerin as an antihypertensive, a hyperosmolar agent, methylprednisolone, and a free radical scavenger. Postpartum women may have the risk of development of RPLS even without preeclampsia-eclampsia. Vascular endothelial dysfunction may trigger RPLS, in addition to acute and modest increase in systemic pressure.
Uwatoko
Takeshi
T
Department of Cerebrovascular Disease, National Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563.
Toyoda
Kazunori
K
Hirai
Yuko
Y
Shimada
Toshifumi
T
Yasumori
Kotaro
K
Ibayashi
Setsuro
S
Okada
Yasushi
Y
D000328:Adult; D018660:Blood Pressure Monitoring, Ambulatory; D001929:Brain Edema / Q000175:diagnosis / Q000188:drug therapy / Q000209:etiology; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000175:diagnosis / Q000188:drug therapy; D008279:Magnetic Resonance Imaging; D011644:Puerperal Disorders / Q000175:diagnosis / Q000188:drug therapy; D013577:Syndrome