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一个(亟待)解决的问题:两例妊娠及产后的后部可逆性脑病综合征(PRES)

A (PRES)sing Matter: Two Cases of Posterior Reversible Encephalopathy Syndrome (PRES) in Pregnancy and Postpartum.

作者信息

Vennapusa Jithin Reddy, Godavarthy Prabhav Kashyap, Garikipaty Shreya, Kulkarni Maitri, Chippa Sangeeta

机构信息

Department of Obstetrics and Gynaecology, Mamata Academy of Medical Sciences, Hyderabad, IND.

出版信息

Cureus. 2025 Feb 18;17(2):e79255. doi: 10.7759/cureus.79255. eCollection 2025 Feb.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a rare but serious neurological condition characterized by headaches, seizures, vision disturbances, and altered mental status. While it is commonly associated with hypertensive disorders, including preeclampsia and eclampsia, its exact pathophysiology remains unclear. We discuss the cases of two obstetric patients diagnosed with PRES: one in antepartum and the other during postpartum. Both exhibited severe hypertension and neurological symptoms, confirmed with neuroimaging, requiring urgent intervention with blood pressure control and seizure prophylaxis. Despite the reversible nature of PRES, a delay in diagnosis can lead to significant morbidity. These cases highlight the diverse clinical presentations of PRES and underscore the importance of early diagnosis and aggressive management to prevent complications. Through a discussion of potential underlying mechanisms, imaging findings, and treatment strategies, this report contributes to the growing understanding of PRES in pregnancy and postpartum, emphasizing the need for continued research and awareness.

摘要

后部可逆性脑病综合征(PRES)是一种罕见但严重的神经系统疾病,其特征为头痛、癫痫发作、视力障碍和精神状态改变。虽然它通常与包括先兆子痫和子痫在内的高血压疾病相关,但其确切的病理生理学仍不清楚。我们讨论了两名被诊断为PRES的产科患者的病例:一名在产前,另一名在产后。两人均表现出严重高血压和神经症状,经神经影像学证实,需要紧急进行血压控制和癫痫预防干预。尽管PRES具有可逆性,但诊断延迟会导致严重的发病率。这些病例突出了PRES的多种临床表现,并强调了早期诊断和积极治疗以预防并发症的重要性。通过对潜在潜在机制、影像学表现和治疗策略的讨论,本报告有助于加深对妊娠和产后PRES的理解,强调持续研究和提高认识的必要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/adf0/11835615/004343373754/cureus-0017-00000079255-i01.jpg

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