Presentation
New onset of seizures in a patient with pre-eclampsia. The patient is post-emergency caesarian section.
Patient Data
There is bilateral occipital, and bilateral posterior parietal (right greater than left) vasogenic oedema.
There is asymmetric non-posterior, left frontal, vasogenic oedema.
Features are consistent with posterior reversible encephalopathy syndrome (PRES).
Diffusion and SWI are negative excluding acute infarction and intracerebral haemorrhage.
The pituitary gland is markedly enlarged and consistent with the postpartum state. It measured 11.1 x 10.7 x 18.4 mm (AP x CC X width).
Contrast was not administered.
Case Discussion
Typical features of PRES in a patient with pre-eclampsia, who underwent emergency caesarian section and developed seizures (eclampsia) on day 2 postpartum.
The pituitary gland is dramatically increased in size and volume, however likely normal for the postpartum state and can be reassessed on an elective follow-up MRI scan, especially if there is a clinical concern for a pituitary macroadenoma.
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