Hemorrhagic stroke with intraventricular extension in the setting of acute posterior reversible encephalopathy syndrome (PRES): case report.

We report the case of an eighteen year-old pregnant female with preeclampsia and florid signs and symptoms of posterior reversible encephalopathy syndrome (PRES) in whom intracerebral hemorrhage was evidenced following delivery. Management included blood pressure control, external ventricular drainage and lumboperitoneal shunt. To our knowledge this is the first report of intracranial hemorrhage occurring concurrently with peripartum acute PRES. This case was successfully treated with good outcome upon conclusion of management, thus making awareness of this potentially fatal complication and its suggested management for successful outcome necessary for neurosurgeons, neurologists and intensivists alike.

Hemorrhagic stroke with intraventricular extension in the setting of acute posteriorreversible encephalopathy syndrome (PRES): case report

We report the case of an eighteen year-old pregnantfemale with preeclampsia and florid signs andsymptoms of posterior reversible encephalopathy syndrome(PRES) in whom intracerebral hemorrhage wasevidenced following delivery. Management includedblood pressure control, external ventricular drainageand lumboperitoneal shunt. To our knowledge this isthe first report of intracranial hemorrhage occurringconcurrently with peripartum acute PRES. This casewas successfully treated with good outcome upon conclusionof management, thus making awareness of thispotentially fatal complication and its suggested managementfor successful outcome necessary for neurosurgeons,neurologists and intensivists alike (AU)

Describimos el caso de una mujer embarazada de18 años con preeclampsia y signos y síntomas floridosde leucoencefalopatía posterior reversible (LPR) en laque se evidenció la presencia de hemorragia cerebraltras el parto. El tratamiento de la enferma incluyó elcontrol de la presión arterial, la utilización de drenajeventricular externo y la colocación de una válvulalumboperitoneal. En nuestro conocimiento esta es laprimera descripción en la literatura de la concurrenciade hemorragia intracraneal con la LPR. Este casofue satisfactoriamente tratado con un buen resultado,haciendo que la sospecha y el conocimiento de esta posible fatal complicación y su correcto tratamientosea importante para neurocirujanos, neurólogos eintensivistas (AU)

Kinetics of protein depletion in rat bronchoalveolar lavage fluid following in vitro exposure to nitrogen dioxide.

Upon inhalation, nitrogen dioxide (NO(2)), a strong oxidizing agent, first comes into contact and reacts with the fluids lining the airways of the respiratory tract. These respiratory tract lining fluids (RTLF) form a barrier between the inhaled toxic pollutant and the epithelium which protects the underlying tissue from inflammation. Proteins, mainly albumin, and antioxidants are the major components of the RTLF. Many studies have utilized human blood plasma to study the interaction of an extracellular fluid with ozone. In this study, we used bronchoalveolar lavage fluids (BALF) as a more specific surrogate for rat RTLF, and we utilized the native fluorescence as a marker to investigate the depletion kinetics of naturally-occurring protein following exposure to NO(2) in a controlled flow reactor system. We also studied the depletion kinetics of albumin in a buffered salt solution. The results indicated that: (1) the decay in fluorescence was linearly dependent on the concentration of NO(2), indicating that protein oxidation was first order with respect to NO(2) concentration in both BALF and in buffered albumin solution; (2) the depletion kinetics of protein in BALF was non-linear with respect to substrate concentration; (3) the rate of protein depletion was much slower in BALF than in a buffered solution of albumin, suggesting that the presence of antioxidants in BALF protected proteins from being oxidized by NO(2); and (4) whereas the addition of ascorbic acid to buffered albumin solution significantly attenuated albumin depletion, the addition of glutathione had no effect. This suggested that the reaction rate constant of ascorbic acid was considerably higher than that of glutathione.