후기 분만 후 자간증 환자에서의 추적 경두개 도플러 초음파 소견
Serial Transcranial Doppler Ultrasonographic Findings in a Patient with Late Postpartum Eclampsia
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Postpartum eclampsia usually occurs within 24 hours after delivery. However, eclampsia occurring beyond 48 hours after delivery was also identified and called late postpartum eclampsia. A 36-year-old woman, who had an uneventful delivery, was admitted due to recurrent generalized seizures which developed on the 14th postpartum d a y. On admission, she showed high blood pressure, generalized edema, and proteinuria. Brain MRI revealed abnormal foci of increased signal at bilateral cerebral cortices on FLAIR images. Brain MRA showed faint visualization of both proximal posterior cerebral arteries. Transcranial Doppler ultrasonography (TCD) on the day of admission showed no significant abnormalities and the patient soon recovered. Blood pressure was normalized and proteinuria disappeared over the next several days. However, TCD on the 14th day after admission showed significant increase in flow velocities with low pulsatility indices implying hyperperfusion at both middle cerebral arteries and the findings persisted till the 30th day after admission.
Abstract
Postpartum eclampsia usually occurs within 24 hours after delivery. However, eclampsia occurring beyond 48 hours after delivery was also identified and called late postpartum eclampsia. A 36-year-old woman, who had an uneventful delivery, was admitted due to recurrent generalized seizures which developed on the 14th postpartum d a y. On admission, she showed high blood pressure, generalized edema, and proteinuria. Brain MRI revealed abnormal foci of increased signal at bilateral cerebral cortices on FLAIR images. Brain MRA showed faint visualization of both proximal posterior cerebral arteries. Transcranial Doppler ultrasonography (TCD) on the day of admission showed no significant abnormalities and the patient soon recovered. Blood pressure was normalized and proteinuria disappeared over the next several days. However, TCD on the 14th day after admission showed significant increase in flow velocities with low pulsatility indices implying hyperperfusion at both middle cerebral arteries and the findings persisted till the 30th day after admission.