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子痫前期及脑脊液漏继发产后后部可逆性脑病综合征：一例报告及文献复习

Postpartum posterior reversible encephalopathy syndrome secondary to preeclampsia and cerebrospinal fluid leakage: A case report and literature review.

作者信息

Wang Yu, Zhang Qing

机构信息

Department of Anesthesiology, Zhabei Central Hospital, Shanghai 200071, China.

出版信息

World J Clin Cases. 2022 Oct 6;10(28):10332-10338. doi: 10.12998/wjcc.v10.i28.10332.

DOI:10.12998/wjcc.v10.i28.10332
PMID:36246802
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9561592/
Abstract

BACKGROUND

Postpartum posterior reversible encephalopathy syndrome (PRES) is not uncommon. Its mechanisms and risk factors are not clear.

CASE SUMMARY

A 28-year-old woman underwent cesarean section but had inadvertent dural puncture during epidural anesthesia. To manage the symptoms of intracranial hypotension, crystalloid fluid was infused. However, the patient developed postpartum preeclampsia and PRES. The patient was treated with diazepam and dehydration therapy. The signs of cerebral lesions on magnetic resonance imaging disappeared on postpartum day 7.

CONCLUSION

Postpartum preeclampsia and PRES can develop concomitantly. Treating postdural puncture headaches with infusion of crystalloid fluid may precipitate the development of PRES.

摘要

背景

产后可逆性后部脑病综合征（PRES）并不罕见。其发病机制和危险因素尚不清楚。

病例摘要

一名28岁女性接受剖宫产手术，但在硬膜外麻醉期间意外发生硬膜穿刺。为处理颅内低压症状，输注了晶体液。然而，该患者发生了产后先兆子痫和PRES。患者接受了地西泮和脱水治疗。产后第7天，磁共振成像显示的脑部病变体征消失。

结论

产后先兆子痫和PRES可能同时发生。用晶体液输注治疗硬膜穿刺后头痛可能促使PRES的发生。

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PRES and RCVS: Two Distinct Entities or a Spectrum of the Same Disease?可逆性后部白质脑病综合征（PRES）与可逆性脑血管收缩综合征（RCVS）：两种不同的病症还是同一种疾病的不同表现？
J Stroke Cerebrovasc Dis. 2022 Jun;31(6):106472. doi: 10.1016/j.jstrokecerebrovasdis.2022.106472. Epub 2022 Apr 5.
2
Posterior Reversible Encephalopathy Syndrome with Status Epilepticus Following Surgery for Lumbar Stenosis and Spondylolisthesis.腰椎管狭窄症和腰椎滑脱症手术后出现癫痫持续状态的后部可逆性脑病综合征
World Neurosurg. 2018 Aug;116:309-315. doi: 10.1016/j.wneu.2018.05.174. Epub 2018 Jun 1.
3
Posterior Reversible Encephalopathy Syndrome after Head Trauma Surgery in Pediatric Patient without Any Underlying Disease.
无任何基础疾病的小儿患者颅脑外伤手术后的后部可逆性脑病综合征
Korean J Neurotrauma. 2017 Oct;13(2):167-170. doi: 10.13004/kjnt.2017.13.2.167. Epub 2017 Oct 31.
4
Rapid intracranial pressure drop as a cause for posterior reversible encephalopathy syndrome: Two case reports.快速颅内压下降作为后部可逆性脑病综合征的一个病因：两例报告。
Surg Neurol Int. 2017 Jun 5;8:103. doi: 10.4103/sni.sni_55_17. eCollection 2017.
5
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Anesth Analg. 2017 Apr;124(4):1219-1228. doi: 10.1213/ANE.0000000000001840.
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7
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Pregnancy Hypertens. 2012 Jul;2(3):314. doi: 10.1016/j.preghy.2012.04.248. Epub 2012 Jun 13.