[Hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome with eclampsia, posterior reversible encephalopathy syndrome (PRES), and severe intracerebral hemorrhage in the early postpartum period: a case report].

A 32-year-old woman developed preeclampsia (PE) with hemolysis, elevated liver enzymes, and low platelet count (HELLP) syndrome at 34 weeks of gestation. Despite undergoing emergency cesarean section, adequate blood pressure control, and platelet transfusion, she experienced eclamptic seizures and posterior reversible encephalopathy syndrome (PRES) within 24 hours postpartum, which rapidly progressed to a massive subcortical intracerebral hemorrhage. Multidisciplinary management enabled survival, but she was left with severe neurological sequelae. This case highlights the complex pathological interplay in which endothelial dysfunction associated with PE and HELLP syndrome may precipitate eclampsia and PRES, trigger thrombotic microangiopathy, and ultimately result in catastrophic intracranial hemorrhage. In pregnant women with preeclampsia complicated by HELLP syndrome, early recognition of overlapping manifestations and the risk of postpartum deterioration is essential, underscoring the need for comprehensive multidisciplinary care.