CLINICAL AND RADIOLOGICAL APPROACH OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME ON ECLAMPSIA

Posterior reversible encephalopathy syndrome (PRES) is rare clinico-neuroradiologic condition and not  commonly reported in the literature, a recently recognized syndrome characterized clinically by  headache, confusion, seizure and visual loss associated, with imaging findings of bilateral cortical and  subcortical oedema, predominantly posterior cerebral lesions (mainly occipito-parietal). Posterior  reversible encephalopathy syndrome is an uncommon complication of severe preeclampsia/ eclampsia.  The objective of this study is to report PRES case on eclampsia with clinical and radiological approach. We  report a case of woman, 34 years old woman, with chief complaint tonic clonic general seizure and  sudden headache previously. This patient had pregnancy 8 gestational month and had pregnancy  termination with cesarean section recently. Patient had loss of consciousness, vision disturbance, and  weakness of right extremities, all this symptom become well during treatment. The result of laboratory  examination was HELLP syndrome (haemolysis, elevated liver enzymes and low-platelets). Head CT scan  showed hypodense lesion in left parietooccipital region and MRI on T2W and T2FLAIR ADC MAPS found  hyperintens lesion in right and left parietooccipital. Then it can be concluded that it have been reported  cases of eclampsia with PRES with symptom of headache, seizure, mental status disturbance, visual  disturbances. The pathological association between PRES and HELLP syndrome in a patient with eclampsia  is poorly described.