Report And Literature Analysis Of The Case Of Posterior Reversible Encephalopathy Syndrome After Cesarean Section

Objective:Starting from the rare clinical cases,this paper discusses the clinical manifestations,imaging characteristics,pathogenesis,diagnosis and treatment methods of patients with posterior reversible encephalopathy syndrome(PRES)after cesarean section to further enriches the knowledge of maternal PRES,and provides more clinical guidance for the diagnosis and treatment of PRES.Methods:In this paper,we summarize a case of women with PRES after cesarean section in our hospital in 2017,and report on it’s onset symptoms,diagnosis and treatment process,therapeutic effects and follow-up results.Combined with relevant literature,we elaborate the etiology,clinical manifestations,imaging examination,diagnostic criteria,treatment methods and prognosis of puerperal related PRES,and guide the clinical practice.Results:This is a case of cesarean section woman,with gestational diabetes mellitus and intrahepatic cholestasis of pregnancy(ICP),before operation diet was given to control blood sugar.After diagnosis of ICP,cholecholic acid was reduced actively.The case became complicated with PRES on the first day after cesarean section.The main manifestations were epilepsy and loss of consciousness.Sedation was given immediately.After symptom relief,computed tomography(CT),magnetic resonance imaging(MRI),magnetic resonance venography,(MRV)and other examinations were performed.After excluding other possible related differential diagnosis,the final diagnosis was PRES.After active treatment,the clinical symptoms and imaging changes were completely recovered,the patient’s prognosis was good,and no related neurological sequelae was left.Conclusions:PRES is a rare disease in clinical practice.It is mainly manifested as epilepsy,disturbance of consciousness,headache,visual disturbance and focal nervous system injury.PRES is still an exclusive disease,which is difficult to differentiate and diagnose.Especially in pregnant women,due to the lack of understanding of the disease by obstetricians and gynaecologists,it is also misdiagnosed as eclampsia and other diseases.The disease is lack of specific treatment.Clinically,it is due to the lack of specific treatment procedure.And symptomatic treatment,such as the removal of inducement or the treatment of primary disease,blood pressure reduction,epilepsy control,etc.,usually has a good prognosis,reversible brain lesions,but once delayed diagnosis and treatment,reversible encephalopathy can also develop into irreversible damage,leaving neurological sequelae,or even death,so early diagnosis and treatment is very important.