1/18. Is high cerebral perfusion pressure and cerebral flow predictive of impending seizures in preeclampsia? A case report.Transcranial Doppler ultrasound was used to demonstrate elevated estimated cerebral perfusion pressure (CPP) and cerebral flow index (CFI) in a preeclamptic patient. She subsequently developed eclampsia. After magnesium sulfate therapy her CPP and CFI were within the normal range and she did not experience further seizures. This finding suggests that cerebral overperfusion may be at least one of the etiologies involved in the pathogenesis of eclampsia.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/18. Cerebrovascular accident with quadriplegia following postpartum eclampsia.A 26-year-old woman (para 1 0) was managed at the National Hospital, Abuja, nigeria for postpartum eclampsia with quadriplegia following referral from a peripheral hospital with a history of a solitary tonic/clonic seizure and unconsciousness. Her antenatal period had been uneventful until she presented with labour pains, where examination revealed an elevated blood pressure. She fitted once after delivery and remained unconscious for more than 12 h, hence the referral. The patient was managed in the intensive care unit (ICU), where she was found to be quadriplegic. She received mechanical ventilation for 21 days as part of her management in the ICU. Despite multidisciplinary care, she remained quadriplegic until a doctors' strike precluded further in-patient management. This rare complication of eclampsia is discussed, together with the patient's management.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
3/18. Eclamptic subarachnoid haemorrhage without hypertension.Subarachnoid haemorrhage in pregnancy is often the result of aneurysmal rupture or severe hypertension. A young woman with postpartum eclampsia and 'normal' blood pressure developed sudden-onset head pain, and was found to have minor biconvexity subarachnoid hemorrhages. Serial angiograms of the cervicocranial vessels revealed no evidence of aneurysm or arteriovenous malformation. A follow-up angiogram revealed diffuse vessel narrowing, consistent with postpartum angiopathy. Treatment consisted only of nimodipine for the prevention of vasospasm. The patient made an excellent recovery, without residual neurological deficits.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
4/18. Posterior reversible encephalopathy syndrome: a case study.A young woman 4 days postpartum was admitted after experiencing two seizures. Her mentation waxed and waned until, after several hours, staff were unable to arouse her with voice or touch. A computed tomography scan demonstrated considerable white-matter edema. The patient's condition declined to a coma. She remained comatose despite therapeutic interventions to control increased intracranial pressure. To her family, her condition was a source of anguish. To the physicians and nurses, she was a puzzle. The final diagnosis was posterior reversible encephalopathy syndrome, which was related to a preeclamptic condition and its associated hypertension. The collaboration of obstetricians and neurologists with vigilant care by neuroscience nurses resulted in a positive outcome for this challenging patient.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
5/18. Cortical blindness in postpartum preeclampsia progressing to eclampsia: case report.A 23-year-old woman who had an uneventful prenatal course and normal delivery developed severe, generalized headache and blurred vision on postpartum day four. The patient was noted to have generalized hyperreflexia and sustained ankle clonus. The blood pressure was 170/100 mm Hg, there was no edema, and the urine showed trace proteinuria. The visual disturbance rapidly progressed to complete blindness with preserved pupillary reactions. The patient then had a generalized tonic-clonic seizure lasting about one minute. Treatment was initiated with intravenous diazepam and phenytoin, and there was no recurrence of seizure activity. Vision returned to normal and the patient made a complete recovery. This case is presented to demonstrate progressive postpartum pre-eclampsia and the importance of early recognition and treatment. Pathophysiologic mechanisms and treatment options are discussed.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
6/18. pseudotumor cerebri following eclampsia.pseudotumor cerebri, or increased intracranial pressure without a mass lesion, has been associated with hormonal activity but the exact causative relation is still obscure. We report a case of a 15-year-old girl who developed pseudotumor cerebri manifested by headache, visual symptoms and extraocular muscle palsies 3 weeks after recovering from eclampsia. Possible associations with eclampsia and postpartum changes in estrogen, progesterone and prolactin are discussed.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
7/18. Balint's syndrome following eclampsia.A young female patient sustained bilateral parieto-occipital infarcts and presented with Balint's syndrome following treatment of eclampsia and caesarean section. Altered cerebral blood flow autoregulation and raised intracranial pressure due to eclampsia probably resulted in impaired cerebral perfusion and borderzone cerebral ischaemia in this patient. Careful reduction of blood pressure in patients with eclampsia is emphasized.- - - - - - - - - - ranking = 0.4keywords = pressure (Clic here for more details about this article) |
8/18. Postpartum eclampsia.Reported is the case of an 18-year-old woman, nine days postpartum, who presented to the emergency department with slightly elevated blood pressure, headache, and blurred vision. She had minimal swelling of her face and hands. The patient then began having focal seizure activity. A diagnosis of postpartum eclampsia was made, and she was started on IV magnesium sulfate and hospitalized. The patient responded well to IV magnesium sulfate and required no antihypertensives. The subtle presentation of a nine-day postpartum patient who developed eclampsia, and additional points of controversy and differential diagnoses are discussed.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
9/18. association of eclampsia and hydatidiform mole: case report and review of the literature.A patient with a hydatidiform mole complicated by eclampsia is presented. The findings from 57 other cases discovered in a review of the literature since 1866 are summarized to define the clinical characteristics of women experiencing eclampsia as a manifestation of their hydatidiform mole. Eclampsia complicating a molar pregnancy is generally preceded by typical preeclamptic symptomatology and uniformly by severely elevated blood pressure. Neurological or visual symptoms also commonly warn of impending eclampsia. Although the reported cases of eclampsia complicating molar pregnancies are rare, this risk argues for the liberal use of prophylactic antiseizure medication when caring for women with a hydatidiform mole and hypertension, neurological complaints, or other preeclamptic symptoms.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
10/18. Active management of the unconscious eclamptic patient.Of the many complications which may develop after eclamptic seizures, prolonged unconsciousness is one of the most difficult for obstetricians to manage as the pathophysiology of this condition remains largely unknown. Computed axial tomography (CT scan) was performed on 20 unconscious eclamptic patients, and autopsy was obtained on an additional two patients. Changes compatible with cerebral oedema were demonstrated in 75% of patients; cerebral haemorrhage occurred in 9%. A programme of intensive neurological management aimed at optimizing cerebral perfusion and controlling intracranial pressure is outlined. We have reduced the mortality rate for unconscious eclamptic patients from 50% to 17% in our institution.- - - - - - - - - - ranking = 0.2keywords = pressure (Clic here for more details about this article) |
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