Diffusion-weighted images and vasogenic edema in eclampsia

Background: In eclampsia, it is mandatory to recognize specific cerebrovascular complications before initiation of treatment. Diffusion-weighted magnetic resonance imaging (MRI) is a new technique that differentiates between cerebral infarction and hypertensive encephalopathy with vasogenic edema. Case: A 23-year-old primigravida developed eclampsia at 29 weeks' gestation. Focal neurologic signs and neuroimaging findings by computed tomography and MRI were consistent with acute infarction or vasogenic edema. Diffusion-weighted MRI did not show an abnormal signal, indicating vasogenic edema. Control of the severe hypertension without anticoagulation therapy was begun. After delivery, the woman's neurologic abnormalities disappeared. Conclusion: Diffusion-weighted MRI differentiated between cerebral infarction and vasogenic edema, helping in the management of eclampsia. (Obstet Gynecol 1999;93: 821-3. (C) 1999 by The American College of Obstetricians and Gynecologists.).