Neurological complications of preeclampsia and eclampsia

Preeclampsia is a disorder specific to pregnancy which can affect all mater nal organs. Cerebral involvement with the occurence of convulsions is the d efining factor for eclampsia The most prominent signs of cerebral dysfuncti on include headache, hyperreflexia,visual disturbances, confusion and/or al tered state of consciousness. Patients usually recover completely however s ome patients remain disabled due to cerebrovascular damage. Intracerebral a nd subarachnoidal hemorrhage are severe however rare complications of eclam psia. TCD investigations regularly find vasospasm in all great cerebral art eries. Reversible hypodense lesions in the white matter on early CT-scans a nd increased signal intensities on T-2-weighted MRT images indicate local e dema. The etiology of preeclampsia and eclampsia remains unknown and its cu rrent pathophysiology is still hypothetical. The clinical picture may best be explained by an endothelial dysfunction with increased vascular sensivit y to circulating pressure agents as well as by a structural endothelial les ion with fluid loss from the intravascular compartment.