scholarly journals Clinical spectrum of patients with posterior reversible encephalopathy syndrome

2020 ◽  
Vol 7 (10) ◽  
pp. 1537
Author(s):  
Sriramchandra Rahul Pulavarty ◽  
Nagabhushana Midathala
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Tertiary Care ◽  
Severe Anaemia ◽  
Sudden Onset ◽  
Common Symptom ◽  
Care Hospital ◽  
Imaging Features ◽  
Posterior Reversible Encephalopathy ◽  
Altered Sensorium ◽  
Reversible Encephalopathy

Background: Posterior reversible encephalopathy syndrome is a neurological disorder which can present with sudden onset headache, visual disturbances, seizures and altered sensorium which is potentially reversible with early detection and treatment of the precipitating factor. The range of presentations is being constantly widened and this endeavour is a step towards understanding the wide array of presentation and primary etiology.Methods: This is a prospective observational study of 25 patients presenting to a tertiary care hospital with symptoms and imaging features suggestive of PRES. Thorough clinical examination and MRI brain were performed in all patients.Results: Out of the 25 patients, 18 (72%) were females and 7 (28%) were males. Most common symptom was headache (84%) followed by seizures (56%), nausea (40%), visual blurring (36%) and altered sensorium (20%). In patients presenting with seizure, 28.57% had recurrent seizures.The most common precipitating cause was postpartum state without hypertension (40%) followed by accelerated hypertension (28%), eclampsia (16%), chronic kidney disease (12%) and one patient of chronic severe anaemia had PRES following blood transfusion (4%). Most of the patients improved with no residual neurological deficit.Conclusions: Good neurological outcomes can be achieved by early diagnosis and appropriate imaging in patients with PRES. In pregnant and postpartum patients, PRES should be always considered even with normal blood pressure. Rapid correction of chronic severe anaemia is a rare but preventable cause of PRES.

scholarly journals Maternal and perinatal outcome in eclampsia complicated by posterior reversible encephalopathy syndrome; a three years’ experience in a tertiary care hospital

2017 ◽  
Vol 6 (11) ◽  
pp. 5044
Author(s):  
Shashikala Karanth Karanth ◽  
Kavitha Gonsalves ◽  
Sheela C. N. ◽  
Reena Mathew ◽  
G. R. K. Sarma ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Perinatal Outcome ◽  
Tertiary Care ◽  
Perinatal Outcomes ◽  
Neurological Symptoms ◽  
Care Hospital ◽  
Mortality And Morbidity ◽  
Posterior Reversible Encephalopathy ◽  
Presenting Symptoms ◽  
Reversible Encephalopathy

Background: PRES can be associated with number of medical conditions and was observed frequently in patients with preeclampsia and eclampsia. Neuroimaging is important for the diagnosis of PRES. Study was conducted to find out the maternal and perinatal outcome in patients with eclampsia complicated by posterior reversible encephalopathy syndrome (PRES).Methods: This is a retrospective study done at St. Johns Medical College Bangalore, between October 2013 and October 2016. We reviewed case records of all the patients with eclampsia who underwent neuro imaging studies and a diagnosis of PRES was made. The maternal and perinatal outcomes in these women were studiedResults: In the past three years we had 55 cases of eclampsia who underwent neuroimaging studies for persistent neurological symptoms after 24 hours of MgSO­4 treatment. Of these women 30 were diagnosed to have PRES. In the present study PRES was common in multiparous women and more in patients with antepartum eclamptic women. Mean age at diagnosis of PRES was 26±5.1 years. Common presenting symptoms were headache (93.3%) and vomiting (53.3%). The mean SBP/DBP was 180/110 mmHg. All patients who had recurrent seizures were controlled with MgSO­4 alone. 53.3% of our patients had eclampsia related complications and 36.7% required ICU care. There were 3 maternal deaths (10%). Perinatal mortality was 20%.Conclusions: Neuroimaging in eclamptic patients with persistent neurological symptoms could help in early diagnosis of PRES and multidisciplinary approach in management could contribute significantly in reducing the maternal mortality and morbidity.

scholarly journals Clinico-radiological spectrum of obstetric patients with posterior reversible encephalopathy syndrome in a tertiary care hospital

2021 ◽  
Vol 9 (3) ◽  
pp. 701
Author(s):  
Neenu Alexander ◽  
C. Justin
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
South India ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Imaging ◽  
Neuro Imaging ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Background: Posterior reversible encephalopathy syndrome (PRES) is a disorder that is not uncommon in pregnancy induced hypertension. We have studied the clinico radiological profile of such patients to understand history, symptomatology and neuro imaging findings of this entity.Methods: The present study included 20 patients of PRES among the inpatients of a tertiary care hospital in south India from January to March 2020.Results: Mean age 25.0 years. Most common symptoms included seizures and headache followed by vomiting, visual disturbances.9 patients (45%) had parieto-occipital signal changes on neuro imaging. Magnetic imaging resonance (MRI) (n=20) revealed involvement of atypical sites viz. frontal (30%), temporal (20%), cerebellum (20%), basal ganglia (20%), deep white matter (30%) and brainstem (10%).Diffusion restriction was seen in 40% patients.Conclusions: Atypical MRI presentations of PRES are common and there is a need to consider a strong possibility for the diagnosis of PRES.

scholarly journals Posterior reversible encephalopathy syndrome following post-streptococcal glomerulonephritis

2013 ◽  
Vol 12 (3) ◽  
pp. 341-343
Author(s):  
Giordano Rafael Tronco Alves ◽  
Isadora Cristina Olesiak Cordenonsi ◽  
Régis Vinícius de Andrade Silva ◽  
Carlos Jesus Pereira Haygert
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Chronic Renal Disease ◽  
Vasogenic Edema ◽  
Medical Science ◽  
Clonic Seizure ◽  
Imaging Features ◽  
Posterior Reversible Encephalopathy ◽  
Inflammatory Conditions ◽  
Post Streptococcal Glomerulonephritis ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) comprises a unique pattern of brain vasogenic edema that is seen in the setting of a neurotoxic status. Besides many etiologies have been already associated with PRES development, such as chronic renal disease, use of chemotherapy agents and inflammatory conditions, the imaging features are very suggestive and helpful for an appropriate diagnosis. We report here a case of PRES secondary to post-streptococcal glomerulonephritis (PSGN), which evolved successfully after clinical management. An 11-year-old boy was admitted with a typical history and findings of PSGN, associated with sensory alterations, headache and recent tonic-clonic seizure. Computed tomography (CT) scan of the head has revealed bilateral and symmetric hypodense areas, remarkably located at posterior cerebral regions, indicating PRES. Patient received support therapy with diuretics, and antibiotics prescription after discharge. At ambulatory follow-ups, the patient remains asymptomatic, with complete clinical and radiological improvement.Bangladesh Journal of Medical Science Vol. 12 No. 03 July ’13 Page 341-343 DOI: http://dx.doi.org/10.3329/bjms.v12i3.13323

Perioperative posterior reversible encephalopathy syndrome in 2 pediatric neurosurgery patients with brainstem ependymoma

2011 ◽  
Vol 7 (3) ◽  
pp. 235-237 ◽  
Author(s):  
Melanie G. Hayden Gephart ◽  
Bonnie P. Taft ◽  
Anne-Katrin Giese ◽  
Raphael Guzman ◽  
Michael S. B. Edwards
Keyword(s):  
Mr Imaging ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Pediatric Neurosurgery ◽  
Altered Mental Status ◽  
Hemodynamic Instability ◽  
Imaging Features ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Pediatric Neurooncology

Posterior reversible encephalopathy syndrome (PRES) has been described in pediatric neurooncology patients, although it has not been documented perioperatively in pediatric neurosurgery patients not actively receiving chemotherapy. Recently at the authors' facility, 2 cases of PRES were diagnosed perioperatively in children with brainstem ependymoma. Both patients had presented with hypertension, altered mental status, and seizures and demonstrated MR imaging features consistent with PRES. The patients were treated with antiseizure and antihypertension medications, leading to improvement in both clinical symptoms and neuroimaging findings. These cases are the first to document PRES in perioperative pediatric neurosurgery patients not actively receiving chemotherapy. Both patients had ependymoma involving the brainstem, which may have led to intra- and perioperative hemodynamic instability (including hypertension) and predisposed them to this syndrome. An awareness of PRES in similar scenarios will aid in the prevention, diagnosis, and treatment of pediatric neurosurgery patients with this syndrome.

scholarly journals Postpartum Reversible Cerebral Vasoconstriction with Cortical Subarachnoid Hemorrhage and　Posterior　Reversible　Encephalopathy Syndrome Concomitant with Vertebral Artery Dissection Diagnosed by MRI MSDE Method; A Case Report and Review of Literature.

2021 ◽  
Author(s):  
Kenshi Sano ◽  
Atsushi Kuge ◽  
Rei Kondo ◽  
Tetsu Yamaki ◽  
Hiroshi Homma ◽  
...  
Keyword(s):  
Subarachnoid Hemorrhage ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Spin Echo ◽  
Vertebral Artery Dissection ◽  
Sudden Onset ◽  
Artery Dissection ◽  
Posterior Reversible Encephalopathy ◽  
Cerebral Vasoconstriction ◽  
Sequencing Method ◽  
Reversible Encephalopathy

Abstract Background: Headache is one of the most common symptoms that are encountered in the postpartum period. We experienced a rare case of multiple phenomena of postpartum stroke occurred at the same time. Case: A 38-year-old woman experienced sudden onset of thunderclap headache after delivery. We diagnosed cervicocephalic arterial dissection (CAD), and posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) with cortical subarachnoid hemorrhage on the basis of clinical course and neuroradiological findings. Conclusion: Our case was rare in that multiple phenomena of postpartum stroke occurred at the same time. What is remarkable about this case was the confirmation of the reversibility of these pathological conditions through multifaceted evaluations, including the MRI motion-sensitized driven equilibrium 3D turbo spin echo (MSDE) sequencing method.

Sign in / Sign up

Export Citation Format

Share Document