A (PRES)sing Matter: Two Cases of Posterior Reversible Encephalopathy Syndrome (PRES) in Pregnancy and Postpartum.

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a rare but serious neurological condition characterized by headaches, seizures, vision disturbances, and altered mental status. While it is commonly associated with hypertensive disorders, including preeclampsia and eclampsia, its exact pathophysiology remains unclear. We discuss the cases of two obstetric patients diagnosed with PRES: one in antepartum and the other during postpartum. Both exhibited severe hypertension and neurological symptoms, confirmed with neuroimaging, requiring urgent intervention with blood pressure control and seizure prophylaxis. Despite the reversible nature of PRES, a delay in diagnosis can lead to significant morbidity. These cases highlight the diverse clinical presentations of PRES and underscore the importance of early diagnosis and aggressive management to prevent complications. Through a discussion of potential underlying mechanisms, imaging findings, and treatment strategies, this report contributes to the growing understanding of PRES in pregnancy and postpartum, emphasizing the need for continued research and awareness.