DELAYED PERIPARTUM VASCULOPATHY - CEREBRAL ECLAMPSIA REVISITED

Over a 2-year period, we treated 4 postpartum patients with acute neur ologic problems appearing 4 to 9 days after delivery. Three patients e ither had no proteinuria or edema and therefore did not meet all accep ted clinical criteria for the diagnosis of eclampsia. Magnetic resonan ce imaging (MRI) of the brain in all patients demonstrated high-signal foci most prominent in the parieto-occipital regions and the subcorti cal white matter. Cerebral angiogram in 2 patients revealed diffuse va sospasm. In 3 patients, MRI abnormalities resolved. MRI and angiograph ic abnormalities in our patients are identical to those of patients me eting accepted criteria for eclampsia. Our experience suggests that th e current criteria for the diagnosis of eclampsia are too stringent, b oth in terms of clinical picture and days postpartum to cerebral manif estations.