ABSTRACT
 
BACKGROUND: We aimed to evaluate the predictive value of DWI in predicting the neurological manifestation of PE.
 
METHODS: We prospectively evaluated the radiological features of complications of pre-eclamptic patients presented from the Obstetrics department with peri-partum /eclampsia manifestations and confirmed by clinical examination and laboratory findings. Follow up was done within 10-14 days for patients with restriction of diffusion in DWI.
 
Results: The study included 44 patients with pre-eclampsia. The mean age of the included patients was26.9±2.9 years old. The admission systolic blood pressure was 181.8±15.2 mmHg. Twenty-nine patients (65.9%) had neurological manifestations of pre-eclampsia at time of admission. Patients with neurological manifestations, revealed normal MRI findings in 7 patients (24.1%) and abnormal features in 22 patients (75.9%). In terms of atypical presentation of PE, restriction of diffusion accounted for 100% of patients with atypical PE. In addition, we found that the parietal lobe was the most frequently affected lobe, followed by the occipital lobe. The parieto-occipital regions were the most commonly affected areas and represented the typical site of PE. Comparing the gray and white matter involvement with the diffusion characteristics, it was noted that most cortical involvement revealed restricted diffusion of cytotoxic edema, all white matter involvements revealed enhanced diffusion of vasogenic edema, while mixed grey and white matter involvement revealed mixed diffusion properties (vasogenic and cytotoxic) with the cytotoxic edema located mainly in the grey matter (p < 0.0005).
 
Conclusions: We suggest that DWI in PE patients with new neurological symptoms should be considered early in their management.