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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.

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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