Reversible Posterior Encephalopathy Syndrome Followed by MR Angiography-Documented Cerebral Vasospasm in Preeclampsia-Eclampsia: Report of 2 Cases

摘要

Posterior reversible encephalopathy syndrome (PRES) is a rare complication of preeclampsia-eclampsia . The characteristic neuroradiological findings are multifocal and often symmetric, increased T2 or diffusion-weighted signal intensity lesions in the posterior dominant white and gray matter . Diffusion tensor imaging (DWI) changes support the hypothesis that vasogenic edema is the pathophysiological mechanism underlying this syndrome . Several reports, however, associate PRES with cytotoxicedema, ischemic stroke, and angiographic vasospasm [3-6]. These findings suggest an interrelationship between PRES and cerebral vasospasm. We report two preeclamptic-eclamptic patients with clinical and neuroradiological features of PRES. In these patients, MR angiography (MRA) showed reversible vasospasm of large- and medium-sized cerebral arteries. The vasospasm was not present initially, and was preceded by the development of vasogenic edema.