Year: 2026 | Month: July-September | Volume: 11 | Issue: 3 | Pages: 74-83
DOI: https://doi.org/10.52403/ijshr.20260309
Computed Tomography and Magnetic Resonance Imaging Findings in Eclampsia-Associated Posterior Reversible Encephalopathy Syndrome: A Retrospective Observational Study
Tauseef Manihar1, Pankaj Asaram Badarkhe2, Shamama Aizaz Khan3
1Junior Resident, Department of Radiodiagnosis, Government Medical College, Akola, Maharashtra - 444001, India.
2Associate Professor, Department of Radiodiagnosis, Government Medical College, Akola, Maharashtra - 444001, India.
3Junior Resident, Department of OBGY, SETH GS medical college, Mumbai 400012.
Corresponding Author: Dr. Tauseef Manihar
ABSTRACT
Background: Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological disorder commonly associated with hypertensive disorders of pregnancy, particularly eclampsia. Early neuroimaging is essential for prompt diagnosis, assessment of disease extent, and identification of imaging features associated with severe neurological injury. This study evaluated the spectrum of computed tomography (CT) and magnetic resonance imaging (MRI) findings in patients with eclampsia-associated PRES.
Materials and Methods: This retrospective observational study included 30 women aged 18–28 years with clinically diagnosed pre-eclampsia or eclampsia presenting with acute neurological manifestations who underwent neuroimaging. Non-contrast CT of the brain was performed in 24 patients, while MRI including T1-weighted, T2-weighted, FLAIR, diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), and susceptibility-weighted imaging/gradient echo (SWI/GRE) sequences was performed in six patients. Imaging findings were evaluated for lesion distribution, laterality, edema pattern, diffusion restriction, and hemorrhagic complications. Data were analyzed descriptively using frequencies and percentages.
Results: CT demonstrated bilateral subcortical vasogenic edema predominantly involving the parietal (91.7%) and occipital (79.2%) lobes, with atypical frontal (37.5%) and temporal (45.8%) extension in several patients. Subarachnoid hemorrhage was identified in 12.5% of CT examinations. MRI revealed parieto-occipital involvement in all patients, with additional abnormalities involving the frontal lobes, temporal lobes, basal ganglia, corpus callosum, and cerebellum. Diffusion restriction suggestive of cytotoxic edema was observed in three patients, while hemorrhagic components were detected in four patients on SWI/GRE sequences.
Conclusion: Eclampsia-associated PRES most commonly manifests as bilateral parieto-occipital vasogenic edema, although atypical multilobar involvement is frequent. CT remains an effective initial imaging modality in emergency settings, whereas MRI provides superior tissue characterization and improved detection of diffusion restriction and hemorrhagic lesions, facilitating comprehensive evaluation of disease extent and imaging severity.
Keywords: Posterior reversible encephalopathy syndrome; eclampsia; computed tomography; magnetic resonance imaging; vasogenic edema; diffusion-weighted imaging