Objective: This study was undertaken to evaluate the hypothesis that severe preeclampsia and eclampsia are associated with unique cranial magnetic resonance images.
Design: Case series of women with severe preeclampsia and eclampsia.
Setting: Referral center.
Patients: Sixteen women with severe preeclampsia and 10 women with eclampsia.
Results: Half of the women with severe preeclampsia had abnormal scans with nonspecific foci of increased signal in the deep cerebral white matter on T2-weighted images. However, women with eclampsia had either a multifocal area of increased signal at the gray-white matter junction on T2-weighted images or cortical edema and hemorrhage. These findings are consistent with necropsy descriptions of cortical edema and petechial hemorrhage. Basal ganglion lesions were also common.
Conclusions: These findings appear to be unique to eclamptic women and should be considered of diagnostic significance in contrast to the nonspecific changes in patients with severe preeclampsia. Cranial magnetic resonance imaging may, thus, be of value in cases with diagnostic uncertainty, atypical presentation, or focal neurologic deficit.