title: Reversible posterior leukoencephalopathy syndrome in a postpartum woman without eclampsia.
abstract: 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.
authors.affiliation: Department of Cerebrovascular Disease, National Kyushu Medical Center, 1-8-1 Jigyohama, Chuo-ku, Fukuoka 810-8563.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Uwatoko
authors.forename: Kazunori
authors.initials: K
authors.lastname: Toyoda
authors.forename: Yuko
authors.initials: Y
authors.lastname: Hirai
authors.forename: Toshifumi
authors.initials: T
authors.lastname: Shimada
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yasumori
authors.forename: Setsuro
authors.initials: S
authors.lastname: Ibayashi
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Okada
mesh_terms: 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