Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10332
Peer-review started: June 7, 2022
First decision: June 16, 2022
Revised: July 28, 2022
Accepted: August 25, 2022
Article in press: August 25, 2022
Published online: October 6, 2022
Processing time: 112 Days and 9.3 Hours
Postpartum posterior reversible encephalopathy syndrome (PRES) is not uncommon. Its mechanisms and risk factors are not clear.
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.
Postpartum preeclampsia and PRES can develop concomitantly. Treating postdural puncture headaches with infusion of crystalloid fluid may precipitate the development of PRES.
Core Tip: Posterior reversible encephalopathy syndrome (PRES) is often associated with hypertension and eclampsia. Here, we report a case of postpartum PRES secondary to preeclampsia and intracranial hypotension caused by dural puncture and cerebrospinal fluid leakage. This case highlights the risk of PRES in laboring women with intracranial hypotension secondary to cerebrospinal fluid leakage and hypertension caused by intraspinal anesthesia.