Case Reports of Pregnant Women with Posterior reversible encephalopathy syndrome

Case Reports of Pregnant Women with Posterior reversible encephalopathy syndrome | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Case Report Case Reports of Pregnant Women with Posterior reversible encephalopathy syndrome Huifang Ren, Heng Fan, Qinggang Ge This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-9459724/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 6 You are reading this latest preprint version Abstract Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical radiological syndrome, Which typically presenting with headache, visual disturbances, seizures, and altered consciousness. It may present acutely or sub-acutely, with symptoms developing over hours to days. Magnetic resonance imaging (MRI) is currently the primary diagnostic imaging modality for this condition, which hallmark findings is subcortical white matter lesions primarily located in the parietal and occipital lobes. This disease is relatively rare. Which detected and diagnosed early, with appropriate intervention, the damage can be completely reversed. If not promptly treated, it may progress to malignant cerebral edema and brain herniation, leading to death and irreversible damage. Therefore, timely and accurate diagnosis of this disease is crucial. Reversibility Posterior circulation (occipitoparietal) White matter encephalopathy Figures Figure 1 Figure 2 Figure 3 Clinical Case A 31-year-old pregnant woman, In Vitro Fertilization and Embryo Transfer (IVF-ET). Gestational 34 + 3 weeks. experienced unexplained left abdominal tightness and right abdominal pain. Postprandial epigastric discomfort with nausea, no vomiting, no diarrhea, no vaginal bleeding or discharge. Presented to the emergency department. She reported no history of dizziness, headache, blurred vision. On physical examination, Perceived fetal movements were good. Uterine tone was good. Fetal heart rate (FHR) 130–140 bpm, reactive fetal heart rate pattern. Uterine contraction curve showed one contraction detectable within 12 minutes. examination of Laboratory was Alanine transaminase (ALT) 292 U/L, Aspartate transaminase (AST) 208 U/L, Creatinine (Cr) 154 µmol/L, Lactate dehydrogenase (LDH) 355 U/L, Prothrombin time (PT) 17.2 s, Prothrombin activity (PA) 51%, Fibrinogen (Fib) 0.83 g/L, Activated partial thromboplastin (APTT) 44 s, D-dimer 8.17 µg/ mL. A diagnosis of acute fatty liver of pregnancy was made. Upon admission, emergency preparation for surgery was initiated. An emergency lower segment cesarean section with bilateral uterine artery ligation was performed, resulting in the delivery of two live infants. Intraoperative blood loss totaled 300 m L. During the procedure, 800 mL of plasma, 6 g of fibrinogen, and 400 IU of prothrombin complex were administered. Postoperatively, the patient was transferred to the critical care unit with invasive mechanical ventilation support. Postoperative complications included bradycardia, seizures( Figure 1 ), jaundice, and coagulation abnormalities. An emergency hospital-wide consultation was convened, a diagnosis of acute fatty liver of pregnancy causing multi-organ dysfunction. Treatment included magnesium sulfate for spasm relief, plasma exchange, and hepatoprotective therapy. Due to frequent seizures, enhanced sedation was administered to maintain airway patency, followed by endotracheal intubation and mechanical ventilation. Comprehensive imaging studies including Head CT, MRI༈ Figure 2 ༉, Magnetic Resonance Angiography( MRA), and Magnetic resonance of the cranial veins (CEMRV) were performed. Multiple hospital-wide and external consultations were convened, Finally a diagnosis of posterior reversible encephalopathy syndrome (PRES) was made. Aggressive treatment included mannitol-induced dehydration and intracranial pressure reduction, antispasmodics, sedation, coagulation factor and albumin supplementation, plasma exchange, continuous bedside hemofiltration, cardiac pacemaker placement, and enteral nutrition. The patient recovered well and was discharged. At the one-year follow-up, the patient had fully recovered, and the MRI(( Figure 3 ))imaging findings had also disappeared. Abbreviations PRES: Posterior Reversible Encephalopathy Syndrome MRI: Magnetic Resonance Imaging MRA: Magnetic Resonance Angiography CEMRV: Magnetic Resonance of the Cranial Veins IVF-ET: In Vitro Fertilization and Embryo Transfer FHR: Fetal Heart Rate ALT: Alanine transaminase AST: Aspartate transaminase Cr: Creatinine LDH: Lactate dehydrogenase PT: Prothrombin time PA: Prothrombin activity Fib: Fibrinogen APTT: Activated partial thromboplastin Declarations ● Ethics approval and consent to participate The Peking University Third Hospital approved this study. Due to the retrospective nature of the study, consent has been waived by the IRB. ● Consent for publication Study participants provided written informed consent regarding the publication of the patient personal or clinical information, as well as any images that could identify them in this study. ● Availability of data and materials The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request. Ethics approval and consent to participate ● Competing Interests No Competing Interests. ● Funding No funding support. ● Authors' contributions We express our sincerely gratitude to Prof Huifang Ren , for writing the paper and compiling the images ; to Prof Qing gang Ge , for his guidance in diagnosis and thesis writing ; to Prof Heng Fan ，for Label figures 1-3 and revise it patiently ; R and G wrote the main manuscript; F and R prepared figures 1-3. All authors reviewed the manuscript. ● Acknowledgements We express our sincerely gratitude to the patient for granting permission to publish this information. Footnotes Corresponding author：Qinggang Ge * Intensive Care Medicine Peking University Third Hospital Beijing China [email protected] Additional Declarations No competing interests reported. Supplementary Files Figure1.png Figure2.png figure3.jpg Cite Share Download PDF Status: Under Review Version 1 posted Reviewers agreed at journal 29 Apr, 2026 Reviewers invited by journal 27 Apr, 2026 Editor assigned by journal 27 Apr, 2026 Editor invited by journal 27 Apr, 2026 Submission checks completed at journal 26 Apr, 2026 First submitted to journal 26 Apr, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9459724","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Case Report","associatedPublications":[],"authors":[{"id":633631918,"identity":"9333a3f4-db4d-427b-9bfb-6f08dbef9b25","order_by":0,"name":"Huifang Ren","email":"","orcid":"","institution":"Peking University Third Hospital","correspondingAuthor":false,"prefix":"","firstName":"Huifang","middleName":"","lastName":"Ren","suffix":""},{"id":633631919,"identity":"e50d35f5-8e06-4019-baf0-2ce90ec1b19e","order_by":1,"name":"Heng Fan","email":"","orcid":"","institution":"Hebi Polytechnic","correspondingAuthor":false,"prefix":"","firstName":"Heng","middleName":"","lastName":"Fan","suffix":""},{"id":633631920,"identity":"9c1c4012-fbd3-491f-b1b5-09319de776a5","order_by":2,"name":"Qinggang Ge","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA9klEQVRIiWNgGAWjYDACZgSr4QBDhYQcPwlaGIFazlgYSzYQbx9jAwNjW0XiBkJa+I7zHn75peaO3Xz3xsbDhfMkGDcwMD98dAOPFsnDfGnWMseeJW88c7Dh8MxtEszmDGzGxjl4tBgc5jEzlmA7nGw4I7HhMO82CTbLBh42acJa/gG1zH8I1DJHgsfgAGEtxg8/th22k5dgBGppkJAgqEUSaAszY9/hBAMeoMN4jkkYSDYT8Avf+TPGH398O2wv33748Geemrr6fvbmh4/xaWE4wMAmzcPAkLjhAEyEGY9qqBbmjz8YGOzlGwipHAWjYBSMghELAFYVUc58VX4lAAAAAElFTkSuQmCC","orcid":"","institution":"Peking University Third Hospital","correspondingAuthor":true,"prefix":"","firstName":"Qinggang","middleName":"","lastName":"Ge","suffix":""}],"badges":[],"createdAt":"2026-04-19 06:24:21","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-9459724/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-9459724/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":108941390,"identity":"46db1d7e-80e7-4b35-8497-fe20074515aa","added_by":"auto","created_at":"2026-05-11 05:34:50","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":118866,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eCT Imaging Features of Postoperative Day 1(A), 6(B), and 15(C\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e, C\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e)\u003c/strong\u003e \u0026nbsp;\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eA, no significant abnormality.\u003c/strong\u003e \u003cstrong\u003eB, C\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e, C\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e Multiple patchy hypodense areas are visible in the bilateral frontal, \u003c/strong\u003e\u003cimg width=\"255\" height=\"261\" src=\"file:///C:/Users/khan07/AppData/Local/Temp/msohtmlclip1/01/clip_image002.jpg\"/\u003e\u003cstrong\u003eparietal, temporal, and occipital lobes\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"1.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9459724/v1/eeb3a7ad00678fe1460867ec.jpg"},{"id":108978169,"identity":"beb06d6c-8c35-4370-a500-a06a2e75e13e","added_by":"auto","created_at":"2026-05-11 11:34:32","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":112881,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMR Imaging Features of Postoperative Day 18\u0026nbsp; T2(D\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e,D\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e)，FLAIR(E\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e,E\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e）\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFigure 2\u0026nbsp;\u0026nbsp; MR Imaging Features of One-year postoperative T2(D1 ,D2)，FLAIR(E\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e1 \u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e,E\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(D\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e, D\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e) Extensive patchy hyperintense signal (E\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e, E\u003c/strong\u003e\u003csub\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/sub\u003e\u003cstrong\u003e) hyperintense in bilateral frontal-parietal-occipital lobes\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"2.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9459724/v1/12dd2f42654367fd47cbc1a7.jpg"},{"id":108978306,"identity":"9e9d917c-a936-4660-abc0-79d3966819c3","added_by":"auto","created_at":"2026-05-11 11:36:05","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":112426,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cstrong\u003eMR Imaging Features of One-year postoperative T2(F1,F2)，FLAIR(G1,G2）\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e(F1, F2, G1, G2) Previously noted extensive patchy hyperintense signals are not demonstrated in bilateral frontal-parietal-occipital lobes.\u003c/strong\u003e\u003c/p\u003e","description":"","filename":"3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9459724/v1/e86553055ad98723a6945db3.jpg"},{"id":108979849,"identity":"4d793f03-f462-4cd4-ad5f-2b069286c809","added_by":"auto","created_at":"2026-05-11 12:01:57","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":475177,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9459724/v1/75b2a6ae-72c1-4794-8e29-d0ac93a7829a.pdf"},{"id":108941389,"identity":"674d5a60-8559-4c0f-b34c-d948aad410e0","added_by":"auto","created_at":"2026-05-11 05:34:50","extension":"png","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":245923,"visible":true,"origin":"","legend":"","description":"","filename":"Figure1.png","url":"https://assets-eu.researchsquare.com/files/rs-9459724/v1/5141c0cfb5e8e9e45d642ab2.png"},{"id":108977692,"identity":"083fee4f-be4d-4d32-9197-892d04b7b8b5","added_by":"auto","created_at":"2026-05-11 11:32:33","extension":"png","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":360060,"visible":true,"origin":"","legend":"","description":"","filename":"Figure2.png","url":"https://assets-eu.researchsquare.com/files/rs-9459724/v1/77f7545285fc8681274e12fb.png"},{"id":108977346,"identity":"6ffca891-5947-464a-b648-1875f371c0b0","added_by":"auto","created_at":"2026-05-11 11:31:27","extension":"jpg","order_by":2,"title":"","display":"","copyAsset":false,"role":"supplement","size":63649,"visible":true,"origin":"","legend":"","description":"","filename":"figure3.jpg","url":"https://assets-eu.researchsquare.com/files/rs-9459724/v1/e39696c10c7711c0d5504e86.jpg"}],"financialInterests":"No competing interests reported.","formattedTitle":"Case Reports of Pregnant Women with Posterior reversible encephalopathy syndrome","fulltext":[{"header":"Clinical Case","content":"\u003cp\u003e \u003cb\u003eA 31-year-old pregnant woman, In Vitro Fertilization and Embryo Transfer (IVF-ET). Gestational 34\u003c/b\u003e \u003csup\u003e \u003cb\u003e+\u0026thinsp;3\u003c/b\u003e \u003c/sup\u003e \u003cb\u003eweeks. experienced unexplained left abdominal tightness and right abdominal pain. Postprandial epigastric discomfort with nausea, no vomiting, no diarrhea, no vaginal bleeding or discharge. Presented to the emergency department. She reported no history of dizziness, headache, blurred vision. On physical examination, Perceived fetal movements were good. Uterine tone was good. Fetal heart rate (FHR) 130\u0026ndash;140 bpm, reactive fetal heart rate pattern. Uterine contraction curve showed one contraction detectable within 12 minutes. examination of Laboratory was Alanine transaminase (ALT) 292 U/L, Aspartate transaminase (AST) 208 U/L, Creatinine (Cr) 154 \u0026micro;mol/L, Lactate dehydrogenase (LDH) 355 U/L, Prothrombin time (PT) 17.2 s, Prothrombin activity (PA) 51%, Fibrinogen (Fib) 0.83 g/L, Activated partial thromboplastin (APTT) 44 s, D-dimer 8.17 \u0026micro;g/ mL. A diagnosis of acute fatty liver of pregnancy was made. Upon admission, emergency preparation for surgery was initiated. An emergency lower segment cesarean section with bilateral uterine artery ligation was performed, resulting in the delivery of two live infants. Intraoperative blood loss totaled 300 m L. During the procedure, 800 mL of plasma, 6 g of fibrinogen, and 400 IU of prothrombin complex were administered. Postoperatively, the patient was transferred to the critical care unit with invasive mechanical ventilation support.\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003ePostoperative complications included bradycardia, seizures(\u003c/b\u003eFigure \u003cspan refid=\"Fig1\" class=\"InternalRef\"\u003e1\u003c/span\u003e\u003cb\u003e), jaundice, and coagulation abnormalities. An emergency hospital-wide consultation was convened, a diagnosis of acute fatty liver of pregnancy causing multi-organ dysfunction. Treatment included magnesium sulfate for spasm relief, plasma exchange, and hepatoprotective therapy. Due to frequent seizures, enhanced sedation was administered to maintain airway patency, followed by endotracheal intubation and mechanical ventilation. Comprehensive imaging studies including Head CT, MRI༈\u003c/b\u003eFigure \u003cspan refid=\"Fig2\" class=\"InternalRef\"\u003e2\u003c/span\u003e\u003cb\u003e༉, Magnetic Resonance Angiography( MRA), and Magnetic resonance of the cranial veins (CEMRV) were performed. Multiple hospital-wide and external consultations were convened, Finally a diagnosis of posterior reversible encephalopathy syndrome (PRES) was made. Aggressive treatment included mannitol-induced dehydration and intracranial pressure reduction, antispasmodics, sedation, coagulation factor and albumin supplementation, plasma exchange, continuous bedside hemofiltration, cardiac pacemaker placement, and enteral nutrition. The patient recovered well and was discharged.\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003cb\u003eAt the one-year follow-up, the patient had fully recovered, and the MRI((\u003c/b\u003eFigure \u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e\u003cb\u003e))imaging findings had also disappeared.\u003c/b\u003e\u003c/p\u003e \u003cp\u003e \u003c/p\u003e \u003c/div\u003e"},{"header":"Abbreviations","content":"\u003cp\u003e\u003cstrong\u003ePRES:\u003c/strong\u003e\u0026nbsp; \u003cstrong\u003ePosterior Reversible Encephalopathy Syndrome\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMRI: Magnetic Resonance Imaging\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMRA: Magnetic Resonance Angiography\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCEMRV: Magnetic Resonance of the Cranial Veins\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eIVF-ET:\u003c/strong\u003e \u003cstrong\u003eIn Vitro Fertilization and Embryo Transfer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFHR: Fetal Heart Rate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eALT: Alanine transaminase\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAST: Aspartate transaminase\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCr: Creatinine\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLDH: Lactate dehydrogenase\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePT: Prothrombin time\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePA: Prothrombin activity\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFib: Fibrinogen\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAPTT: Activated partial thromboplastin\u003c/strong\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003e●\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eEthics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eThe Peking University Third Hospital approved this study. Due to the retrospective nature of the study, consent has been waived by the IRB.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e●\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Consent for publication\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; Study participants provided written informed consent regarding the publication of the patient personal or clinical information, as well as any images that could identify them in this study.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e●\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Availability of data and materials\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp;The datasets used and/or analyzed during the current study available from the corresponding author on reasonable request. Ethics approval and consent to participate\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e●\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Competing Interests\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; No Competing Interests.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e●\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Funding\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; No funding support.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e●\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eAuthors\u0026apos; contributions\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; We express our sincerely gratitude to Prof Huifang Ren , for writing the paper and compiling the images ; to Prof \u0026nbsp;Qing gang Ge , for his guidance in diagnosis and thesis writing ; to Prof Heng Fan ，for Label figures 1-3 and revise it patiently ; R and G wrote the main manuscript; F and R prepared figures 1-3. All authors reviewed the manuscript.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e●\u003c/strong\u003e\u003cstrong\u003e\u0026nbsp;Acknowledgements\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e\u0026nbsp; \u0026nbsp; \u0026nbsp;We express our sincerely gratitude to the patient for granting permission to publish this information.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFootnotes\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCorresponding author：Qinggang Ge\u003csup\u003e*\u003c/sup\u003e Intensive Care Medicine Peking University Third Hospital Beijing China \u0026nbsp;[email protected]\u003c/strong\u003e\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-neurology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurl","sideBox":"Learn more about [BMC Neurology](http://bmcneurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurl","title":"BMC Neurology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Reversibility, Posterior circulation (occipitoparietal), White matter encephalopathy","lastPublishedDoi":"10.21203/rs.3.rs-9459724/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-9459724/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003ePosterior Reversible Encephalopathy Syndrome (PRES) is a clinical radiological syndrome, Which typically presenting with headache, visual disturbances, seizures, and altered consciousness. It may present acutely or sub-acutely, with symptoms developing over hours to days. Magnetic resonance imaging (MRI) is currently the primary diagnostic imaging modality for this condition, which hallmark findings is subcortical white matter lesions primarily located in the parietal and occipital lobes. This disease is relatively rare. Which detected and diagnosed early, with appropriate intervention, the damage can be completely reversed. If not promptly treated, it may progress to malignant cerebral edema and brain herniation, leading to death and irreversible damage. Therefore, timely and accurate diagnosis of this disease is crucial.\u003c/p\u003e","manuscriptTitle":"Case Reports of Pregnant Women with Posterior reversible encephalopathy syndrome","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-05-11 05:34:46","doi":"10.21203/rs.3.rs-9459724/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"reviewerAgreed","content":"123128176348118553404922857391455394657","date":"2026-04-29T18:23:59+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-04-27T18:17:08+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-04-27T18:14:44+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2026-04-27T11:43:21+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-04-26T09:21:53+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Neurology","date":"2026-04-26T09:17:59+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-neurology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"nurl","sideBox":"Learn more about [BMC Neurology](http://bmcneurol.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/nurl","title":"BMC Neurology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"bb960131-684a-46dd-8c91-2bd81ec07573","owner":[],"postedDate":"May 11th, 2026","published":true,"recentEditorialEvents":[{"type":"reviewerAgreed","content":"123128176348118553404922857391455394657","date":"2026-04-29T18:23:59+00:00","index":39,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-05-11T05:34:46+00:00","versionOfRecord":[],"versionCreatedAt":"2026-05-11 05:34:46","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9459724","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-9459724","identity":"rs-9459724","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}