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Its most striking clinical feature is loss of memory, which can be permanent. It is usually found in severe alcoholics, but can also result from pernicious vomiting of pregnancy (hyperemesis gravidarum), because the requirement for thiamine is much increased in pregnancy; nearly 200 cases have been reported.
Permanent deficits are seen in a minority of patients, ranging from under 10% to 20% in various studies. [1] Less than 5% of patients experience progressive vasoconstriction, which can lead to stroke, progressive cerebral edema, or even death. [1] Severe complications appear to be more common in postpartum mothers. [6]
Any of the following may be observed – incoherent speech, misidentification of persons, visual hallucinations, inappropriate behavior such as singing, or memory loss for the episode. A phasic course, with alternate delirium and clarity, continuation into the puerperium, and recurrence after another pregnancy have been described in a few cases.
The diagnosis is usually made by a brain scan , in which areas of swelling can be identified. The treatment for PRES is supportive: removal of the cause or causes and treatment of any of the complications, such as anticonvulsants for seizures. PRES may be complicated by intracranial hemorrhage, but this is relatively rare. The majority of ...
Damage to the limbic system involves loss or damage to memory, and may include: [citation needed] loss or confusion of long-term memory prior to focal neuropathy (retrograde amnesia) inability to form new memories (anterograde amnesia) loss of, or reduced emotions ; loss of olfactory functions; loss of decision-making ability
These clots can build up enough so that eventually the artery is clogged and no blood can flow through. [23] In addition to vascular damage, trauma to the fetal head from excessive uterine activity, manipulation, pressure, and forceps or vacuum application via direct occlusion or vasospasm can cause perinatal ischemic stroke. [24]
Headache occurs in greater than 75% of patients. [10] The patient becomes restless. Alterations in consciousness may follow several hours later, which include impaired judgement and memory, confusion, somnolence and stupor. If the condition is not treated, these neurological symptoms may worsen and ultimately turn into a coma.
Intrauterine hypoxia can be attributed to maternal, placental, or fetal conditions. [12] Kingdom and Kaufmann classifies three categories for the origin of fetal hypoxia: 1) pre-placental (both mother and fetus are hypoxic), 2) utero-placental (mother is normal but placenta and fetus is hypoxic), 3) post-placental (only fetus is hypoxic).