Postpartum spinal cord injury in a woman with HELLP syndrome.
OBJECTIVE
To report a rare cause of spinal cord injury.


METHODS
Case report.


METHODS
A 36-year-old woman presented with acute onset of paresis of the upper and lower extremity (level C5, ASIA B) the day after delivering a healthy daughter (39 weeks' gestation). Prior to giving birth, she was admitted with gestational hypertension. Directly postpartum, blood pressure increased markedly, and hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome was diagnosed. The next day, tetraplegia developed. Magnetic resonance imaging showed multiple epidural and subdural hematomas in the cervical and thoracic spinal canal extending from C2 to T8, with displacement and compression of the cord. Three weeks after treatment with intravenous labetalol, she made a significant recovery (level T1, ASIA D).


CONCLUSIONS
This rare cause of spinal cord injury shows the importance of closely monitoring pregnant patients with hypertension complicated with HELLP syndrome both pre- and postpartum.
Groothuis
Jan T
JT
Department of Rehabilitation Medicine, St. Maartenskliniek, Nijmegen, The Netherlands. j.groothuis@maartenskliniek.nl [corrected]
Groothius
Jan T
JT
van Kuppevelt
Dirk H
DH
D000328:Adult; D005260:Female; D017359:HELLP Syndrome / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D049590:Postpartum Period; D011247:Pregnancy; D013119:Spinal Cord Injuries / Q000150:complications*
J Spinal Cord Med. 2007;30(3):205-14
17684886
Neurosurgery. 1997 Aug;41(2):483-6; discussion 486-7
9257319
J Matern Fetal Med. 1997 Jul-Aug;6(4):218-9
9260119
Neurosurgery. 2005 May;56(5):E1156; discussion E1156
15854266
Can J Neurol Sci. 2005 Aug;32(3):361-5
16225182