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Vol. 20. Issue 1.
Pages 57-61 (January 2009)
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Vol. 20. Issue 1.
Pages 57-61 (January 2009)
Hemorrhagic stroke with intraventricular extension in the setting of acute posterior reversible encephalopathy syndrome (PRES): Case report
Infarto hemorrágico con extensión intraventricular en el contexto de leucoencefalopatía aguda posterior reversible (LPR): descripción de un caso
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J. Gasco*,
, L. Rangel-Castilla*, S. Clark**, L. Satchithanandam***, P. Salinas*
* Division of Neurological Surgery at University of Texas Medical Branch, Galveston, Texas
** Division of Maternal-Fetal Medicine at University of Texas Medical Branch, Galveston, Texas
*** Department of Radiology at University of Texas Medical Branch, Galveston, Texas
B. Franklin
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Summary

We report the case of an eighteen year-old pregnant female with preeclampsia and florid signs and symptoms of posterior reversible encephalopathy syndrome (PRES) in whom intracerebral hemorrhage was evidenced following delivery. Management included blood pressure control, external ventricular drainage and lumboperitoneal shunt. To our knowledge this is the first report of intracranial hemorrhage occurring concurrently with peripartum acute PRES. This case was successfully treated with good outcome upon conclusion of management, thus making awareness of this potentially fatal complication and its suggested management for successful outcome necessary for neurosurgeons, neurologists and intensivists alike.

Key words:
Preeclampsia
PRES
Reversible encephalopathy
Intracranial hemorrhage
Intraventricular hemorrhage
External ventriculostomy drainage
Resumen

Describimos el caso de una mujer embarazada de 18 años con preeclampsia y signos y síntomas floridos de leucoencefalopatía posterior reversible (LPR) en la que se evidenció la presencia de hemorragia cerebral tras el parto. El tratamiento de la enferma incluyó el control de la presión arterial, la utilización de drenaje ventricular externo y la colocación de una válvula lumboperitoneal. En nuestro conocimiento esta es la primera descripción en la literatura de la concurrencia de hemorragia intracraneal con la LPR. Este caso fue satisfactoriamente tratado con un buen resultado, haciendo que la sospecha y el conocimiento de esta posible fatal complicación y su correcto tratamiento sea importante para neurocirujanos, neurólogos e intensivistas.

Palabras clave:
Preeclampsia
LPR
Encefalopatía reversible
Hemorragia intracraneal
Hemorragia intraventricular
Drenaje ventricular externo

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