Assessment of vasogenic edema in eclampsia using diffusion imaging

We qualitatively assessed the regional distribution of vasogenic edema in a case of postpartum eclampsia. Although diffusion-weighted imaging showed no abnormalities, bilateral high signal was seen on T2-weighted images and apparent diffusion coefficient (ADC) maps. ADC of 1.45 +/- 0.10 mm(2)/s X 10(-3) for the posterior cerebral artery (PCA) territory and 1.22 +/- 0.12 mm(2)/s x 10(-3) for the watershed areas were significantly higher than those in the territories of the anterior (0.85 +/- 0.07 mm(2)/s x 10(-3)) and middle cerebral (0.79 +/- 0.06 mm(2)/s x 10(-3))arteries (P < 0.05). The predilection of ADC changes within the PCA territory and in a previously undescribed watershed distribution supports the hypothesis that vasogenic edema in eclampsia is due to hypertension-induced failure of vascular autoregulation.