Overlapping features of eclampsia and postpartum angiopathy.
BACKGROUND
Postpartum cerebral angiopathy (PPA) is considered one of a diverse group of rare conditions termed "reversible cerebral vasoconstriction syndromes". Existing literature suggest considerable overlap in the manifestations of eclampsia and PPA.


METHODS
Retrospective case series review of PPA and eclampsia from a single neurosciences intensive care unit patient log identified over a consecutive 18-month period. A MEDLINE search (using OVID) of the English literature from 1950 through October 2008 was also performed.


RESULTS
Four patients who meet the obstetrical criteria for eclampsia and four patients whose clinical and radiographic features were consistent with PPA were identified. Twenty-eight patients with PPA were identified from the literature and showed significant clinical and radiographic overlap without cohort.


CONCLUSIONS
Given the overlapping clinical, laboratory, and radiographical features of eclampsia and PPA, it is probable they share a similar underlying pathophysiological mechanism and represent different clinical expressions of the same pregnancy-related disorder. The obstetrical definition of eclampsia may be to strict when applied in the neurosciences intensive care unit.
Fletcher
Jeffrey J
JJ
Department of Medicine, Michigan State University, Bronson Methodist Hospital, 601 John Street Suite M-124, Kalamazoo, MI 49007, USA. fletchej@bronsonhg.org
Kramer
Andreas H
AH
Bleck
Thomas P
TP
Solenski
Nina J
NJ
D000328:Adult; D002561:Cerebrovascular Disorders / Q000453:epidemiology / Q000503:physiopathology*; D004461:Eclampsia / Q000503:physiopathology*; D005260:Female; D006261:Headache / Q000209:etiology; D006801:Humans; D008775:Methylprednisolone / Q000627:therapeutic use; D009529:Nicardipine / Q000627:therapeutic use; D049590:Postpartum Period; D011247:Pregnancy; D011644:Puerperal Disorders / Q000503:physiopathology*; D012189:Retrospective Studies; D012640:Seizures / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D020521:Stroke / Q000453:epidemiology; D013345:Subarachnoid Hemorrhage / Q000453:epidemiology / Q000503:physiopathology; D014661:Vasoconstriction / Q000502:physiology; D014665:Vasodilator Agents / Q000627:therapeutic use; D014700:Verapamil / Q000627:therapeutic use; D055815:Young Adult
D014665:Vasodilator Agents; D014700:Verapamil; D009529:Nicardipine; D008775:Methylprednisolone