Document Detail

Lethal pontine hemorrhage in postpartum syndrome of hemolysis, elevated liver enzyme levels, and low platelet count.
MedLine Citation:
PMID:  16009775     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: HELLP syndrome (a combination of hemolysis, elevated liver enzyme levels, and low platelet count) is a severe variant of preeclampsia that generally occurs before delivery but can occur post partum. This syndrome is more common than eclampsia and frequently leads to devastating neurological consequences such as intracerebral hemorrhage. OBJECTIVE: Although mentioned in the obstetric literature, there has been sparse reporting in the neurology literature specifically regarding intracerebral hemorrhage in HELLP syndrome. We illustrate such a case and review the existing literature regarding this severe complication. SETTING: Obstetric unit at an academic medical center. PATIENT: A 34-year-old primigravida experienced a pontine hemorrhage and subsequent respiratory arrest 22 hours after a normal delivery. This hemorrhage occurred 7 hours after the sudden onset of hypertension, severe headache, and intermittent abdominal pain. RESULTS: Laboratory and postmortem evidence suggested HELLP syndrome with disseminated intravascular coagulation as the cause of her intracerebral hemorrhage. CONCLUSIONS: Our case suggests the importance of the neurology consultant's familiarity with HELLP syndrome and the need for thorough laboratory testing and close monitoring in the puerperal patient with headache and hypertension.
Lawrence A Zeidman; Aleksandar Videnovic; Lawrence P Bernstein; Chimene A Pellar
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Archives of neurology     Volume:  62     ISSN:  0003-9942     ISO Abbreviation:  Arch. Neurol.     Publication Date:  2005 Jul 
Date Detail:
Created Date:  2005-07-12     Completed Date:  2005-08-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0372436     Medline TA:  Arch Neurol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1150-3     Citation Subset:  AIM; IM    
Department of Neurology, Feinberg School of Medicine, Northwestern University, Chicago, Ill, USA.
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MeSH Terms
Brain Stem / blood supply*,  pathology*
HELLP Syndrome / complications*
Headache / etiology
Hypertension / etiology
Intracranial Hemorrhages / etiology*
Respiratory Insufficiency / etiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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