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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Computed tomography and magnetic resonance imaging findings consistent with eclampsia were recently encountered in 3 patients who developed severe headache days to weeks after uncomplicated delivery. The neurologic presentation was nonspecific, and pre-eclamptic symptoms were not present, including significant hypertension. Variable expression of pre-eclampsia occurred during the course of their observation. Conventional angiography obtained in 2 patients because of a concern for aneurysm demonstrated central and peripheral vasospasm. Magnetic resonance angiography demonstrated central vasospasm in the third patient.
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PMID:Neuroimaging of delayed eclampsia. Report of 3 cases and review of the literature. 1450 61

The difficult types of preeclampsia and eclampsia are presented with the neurological symptoms. The break of cerebral autoregulation mechanism plays the most important role in pathogenesis of cerebral vasospasm. Nevertheless, eclampsia isn't just an ordinary hypertensive encephalopathy because other pathogenic mechanisms are involved in its appearance. The main neuropathologic changes are multifocal vasogenic edema, perivascular multiple microinfarctions and petechial hemorrhages. Neurological clinical manifestations are convulsions, headache, visual disturbances and rarely other discrete focal neurological symptoms. Eclampsia is a high-risk factor for onset of hemorrhagic or ischemic stroke. This is a reason why neurological diagnostic tests are sometimes needed. The method of choice for evaluation of complicated eclampsia is computerized brain topography that shows multiple areas of hypodensity in occipitoparietal regions. These changes are focal vasogenic cerebral edema. For differential diagnosis of eclampsia and stroke other diagnostic methods can be used--fundoscopic exam, magnetic resonance brain imaging, cerebral angiography and cerebrospinal fluid exam. The therapy of eclampsia considers using of magnesium sulfate, antihypertensive, anticonvulsive and antiedematous drugs.
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PMID:[Neurologic aspects of eclampsia]. 1460 66

Preeclampsia developed in this patient 4 days' postpartum. Visual changes, headache, and elevated blood pressures were present on arrival to the emergency department. Coincident with the preeclampsia was a postdural puncture headache complicating the diagnosis of late postpartum preeclampsia. Pregnancy-induced hypertension laboratory values were normal, and relief of the postdural headache and visual disturbances was obtained after placement of an epidural blood patch. Blood pressures continued to increase, however, and late postpartum eclampsia developed. We conclude that symptoms of a postdural puncture headache can mimic those of postpartum preeclampsia. Early recognition and treatment of postpartum preeclampsia may decrease patient mortality and morbidity by preventing late postpartum eclampsia.
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PMID:Late postpartum eclampsia coincident with postdural puncture headache: a case report. 1462 74

We report a patient who developed reversible posterior leukoencephalopathy syndrome (RPLS) in puerperium without preeclampsia-eclampsia or chronic hypertension. The woman suddenly complained of visual loss and headache 10 days after delivery caused by edematous lesions mainly distributed in the bilateral occipital lobe. Apparent diffusion coefficient map was useful for distinction of this vasogenic edema from cytotoxic edema due to brain infarction. Under the diagnosis of RPLS, we successfully treated her disease using a trinitroglycerin as an antihypertensive, a hyperosmolar agent, methylprednisolone, and a free radical scavenger. Postpartum women may have the risk of development of RPLS even without preeclampsia-eclampsia. Vascular endothelial dysfunction may trigger RPLS, in addition to acute and modest increase in systemic pressure.
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PMID:Reversible posterior leukoencephalopathy syndrome in a postpartum woman without eclampsia. 1468 58

Ectopic ACTH syndrome is rarely caused by pheochromocytoma. We report a case of a 28-year-old woman with Cushing's syndrome due to ACTH-producing adrenal pheochromocytoma. She had delivered preterm baby at 32nd week of gestation with 'severe preeclampsia'. After delivery, persistent hypertension accompanied by severe headache led her to being misdiagnosed as Cushing's syndrome due to right adrenal adenoma (normal plasma ACTH level) and cerebral vasculitis of unknown etiology. She was referred to our hospital for surgical treatment. Repeated biochemical studies suggested coexistence of ectopic ACTH syndrome and pheochromocytoma. To reverse her clinical deterioration, right total and left subtotal adrenalectomy was performed with presumptive diagnosis of 1) right adrenal pheochromocytoma causing ectopic ACTH syndrome or 2) coexistence of ACTH-dependent Cushing's syndrome and right adrenal pheochromocytoma. Pathologic examination of right adrenal mass revealed pheochromocytoma which showed strong immunostaining for ACTH. Plasma ACTH and urinary cortisol excretion normalized after surgery, but she succumbed to multiple cerebral infarcts and disseminated intravascular coagulation. Pregnancy and inappropriately low plasma ACTH at initial evaluation might have hampered early diagnosis. To our knowledge, this is the first description of a case with ectopic ACTH syndrome due to pheochromocytoma associated with pregnancy.
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PMID:A case of ACTH-producing pheochromocytoma associated with pregnancy. 1470 46

We present 2 cases, one eclamptic patient and one noneclamptic patient, of headache, cortical blindness, and seizures. Both patients demonstrated findings consistent with posterior leukoencephalopathy syndrome. Posterior leukoencephalopathy syndrome is a rapidly evolving neurologic condition that is characterized by headache, nausea and vomiting, seizures, visual disturbances, altered sensorium, and occasionally focal neurologic deficits. Posterior leukoencephalopathy syndrome can be triggered by numerous conditions, including preeclampsia-eclampsia, and can be seen in the postpartum period. It is characterized predominately by white matter vasogenic edema of the occipital and posterior parietal lobes. This condition can be difficult to differentiate clinically from cerebral ischemia, and magnetic resonance imaging with diffusion-weighted imaging and apparent diffusion coefficient are needed to do so. In most cases of posterior leukoencephalopathy syndrome, the prognosis is excellent, with full resolution of symptoms.
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PMID:Postpartum blindness: two cases. 1474 15

Posterior reversible encephalopathy syndrome is a proposed cliniconeuroradiological entity characterized by headache, altered mental status, cortical blindness, seizures, and other focal neurological signs, and a diagnostic magnetic resonance imaging picture. A variety of different etiologies have been reported like hypertension, pre-eclampsia/eclampsia, cyclosporin A or tacrolimus neurotoxicity, uraemia and porphyria. With early diagnosis and prompt treatment, the syndrome is usually fully reversible. We report a case of recurrent PRES of unknown aetiology following intensive care unit treatment and only moderately elevated blood pressure. Clinicians as well as radiologists must be familiar with this clinically frightening, underdiagnosed condition to assure timely diagnosis and treatment to prevent persistent deficits.
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PMID:Recurrent posterior reversible encephalopathy syndrome (PRES). 1503 79

The splenic rupture is a rare complication of pregnancy and of the postpartum period. On the contrary, hepatic hemorrhage is a relatively common complication of pregnancy and it is usually associated with preeclampsia. In this work we report the case of a 37 year-old patient with a noncontrolled 35 week-pregnancy of simple, with severe preeclampsia. She presented abdominal pain, headache, hypertension and accented cutaneous-mucous paleness at the moment of admission to the hospital. During physical evaluation at admittance, the patient suddenly suffered a severe circulatory collapse and it was decided a surgical intervention. A segmental caesarean section was practiced, and during the abdominal exploration it was observed hemoperitoneous, a splenic rupture degree III and a hematoma in the anterolateral liver's wall. Total splenectomy and evacuation of the hepatic hematoma was performed. The splenic rupture and the hepatic subcapsular hematoma should be considered as a part of the differential diagnoses when a hemodynamic collapse occurs during labor in patients with severe preeclampsia. This work constitutes the first report in the Venezuelan literature of the association of splenic rupture, hepatic subcapsular hematoma and severe preeclampsia. An appropriate prenatal control, the knowledge of this association and an immediate therapeutic intervention are essential to assure the maternal-fetal survival.
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PMID:[Hepatic and splenic rupture associated with severe preeclampsia: a case report]. 1505 59

A prospective controlled, longitudinal study investigated the immediate and delayed complications of epidural analgesia in labour. One hundred and twenty-two parturients were studied: 81 had epidurals in labour and 41 had other forms of analgesia. Each parturient was studied over a period of 6 weeks. Epidural analgesia in labour and delivery is generally safe. Although the epidural group recorded more complications, they tended to be minor ones such as backache, headaches, shoulder and neck pain. Epidural blocks have an added advantage of being helpful in complicated labours like breech presentations, multiple pregnancies, pre-eclampsia, in situations where caesarean section is anticipated and in manual removal of the placenta.
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PMID:Immediate and delayed complications of epidural analgesia in labour and delivery. 1551 33

We present the case of a 29-year-old female who in her third pregnancy developed seizures seven days postpartum. The only symptoms preceding the seizures were headache and visual disturbance. There was no evidence of preeclampsia antepartum or postpartum. All clinical investigations were normal including computerised tomography, magnetic resonance imaging and lumbar puncture. All symptoms resolved within 24 h of the first seizure. In this case report we highlight the difficulties in establishing the cause of postpartum seizures.
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PMID:A case of late postpartum seizures after epidural analgesia. 1579 51


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