A case of eclampsia with intraventricular hemorrhage
Mizobuchi, H.; Arimitsu, T.; Kurisaka, M.; Mori, K.
No Shinkei Geka. Neurological Surgery 16(5 Suppl): 517-522
1988
ISSN/ISBN: 0301-2603 PMID: 3399006 Document Number: 320887
Our case is a 31-year-old primipara who had undergone a cesarean section for multiple pregnancy and was referred to our clinic because of attack of eclampsia. On admission, her consciousness level was lethargic. Computed tomography on admission showed high density area indicating right paraventricular hemorrhage with ventricular perforation, and low density areas in bilateral basal ganglia. Examination of the cerebral angiogram done six days after onset of symptoms revealed multisegmental vasospasm in Willis' circle mainly. An emergent ventricular drainage was performed. Two weeks later, repeat angiogram revealed that spasm had almost disappeared. Repeat CT scan three months after the onset showed small low density area in the right caudate nucleus and disappearance of the low density areas in bilateral basal ganglia. Her clinical course was uneventful and she was discharged without neurological deficit at about three weeks after the onset. In spite of absence of subarachnoid clot on CT scan, remarkable multisegmental spasm was found on cerebral angiogram. We suspected that eclampsia may have been responsible for the spasm in this case. Bleeding was believed to have originated in the superolateral angle of the lateral ventricle. It was supposed that infarcted hemorrhage or bleeding from small artery due to changes in arterial or venous pressure might have occurred and penetrated into the lateral ventricle.