scholarly journals Pediatric posterior reversible encephalopathy syndrome presenting with isolated cerebellar edema and obstructive hydrocephalus

2014 ◽  
Vol 14 (4) ◽  
pp. 344-347 ◽  
Author(s):  
Nicholas Ettinger ◽  
Matthew Pearson ◽  
Fred S. Lamb ◽  
John C. Wellons
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Picture ◽  
Fourth Ventricle ◽  
Severe Hypertension ◽  
Obstructive Hydrocephalus ◽  
Outlet Obstruction ◽  
Hypertensive Emergency ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

In this report, the authors describe the case of a teenage boy who presented with hypertensive emergency, posterior reversible encephalopathy syndrome, and hydrocephalus due to fourth ventricle outlet obstruction. Posterior reversible encephalopathy syndrome is a well-characterized but uncommon syndrome in children that is generally triggered by severe hypertension. The unusual clinical picture of this patient, who had isolated cerebellar edema leading to obstructive hydrocephalus, has been rarely described in children.

Abstract WP220: Can’t Breathe, Can’t See, Can’t Think: Chronic Obstructive Pulmonary Disease Increases the Risk of Posterior Reversible Encephalopathy Syndrome

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Molly Bates ◽  
Kyle Darpel ◽  
Nneka Amadife ◽  
Adam Dugan ◽  
Jessica D Lee
Keyword(s):  
Blood Pressure ◽  
Logistic Regression ◽  
Endothelial Dysfunction ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Hypertensive Emergency ◽  
Categorical Variables ◽  
Multivariate Logistic Regression ◽  
P Values ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Introduction: Several theories exist regarding the pathogenesis of posterior reversible encephalopathy syndrome (PRES). One theory suggests that PRES occurs when systemic blood pressure exceeds the upper limit of cerebral autoregulation. Endothelial dysfunction has been proposed as an alternative pathogenesis to account for PRES outside the setting of acute hypertension. This mechanism has been implicated in other conditions associated with PRES including autoimmune diseases, cytotoxic medications, sepsis, and eclampsia. The purpose of this study was to determine if COPD, a disease known to cause endothelial dysfunction, has a causative association with the development of PRES. Methods: A single center retrospective, age-matched, case-control study was performed from January 2013 to June 2019 comparing patients discharged with a primary diagnosis of PRES to a control group with acute ischemic stroke. Demographics, medical comorbidities, initial blood pressure, and clinical outcomes were compared between the two groups. For categorical variables, p-values were calculated using χ2 and Fisher’s exact tests. For continuous variables, p-values were calculated using two-sample t-tests. The effect of COPD and acute hypoxic respiratory failure on PRES status was investigated using multivariate logistic regression. Results: A total of 94 PRES subjects and 109 control subjects were included for analysis. Mean age did not differ between the two groups; however, the PRES group was more likely to be female (78.7% vs. 49.5%, p<0.001). COPD was present in 26.6% (n=25) of cases and 11% (n= 12) of controls (odds ratio 4.12, p=0.003). Occurrence of hypertension did not differ significantly between the two groups (78.0% vs 86.2%). Among patients with PRES in the setting of COPD (n=25), 60% (n=16) did not meet criteria for hypertensive emergency. Controlling for hypertensive emergency status in a multivariate logistic regression analysis, patients with COPD were 3.21 times more likely to develop PRES (p= 0.004). Conclusions: To our knowledge, very few reports of PRES in the setting of COPD have been described in the literature and no association of PRES and COPD has been defined to date. Our data support the role of COPD as a risk factor in the development of PRES.

Hypertension and Confusion

2016 ◽  
Author(s):  
Ji Y. Chong ◽  
Michael P. Lerario
Keyword(s):  
White Matter ◽  
Brain Imaging ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Course ◽  
Severe Hypertension ◽  
Vasogenic Edema ◽  
Blurred Vision ◽  
Posterior Reversible Encephalopathy ◽  
Immunosuppressive Medications ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome is a clinical–radiographic syndrome of progressive headaches, blurred vision, confusion, and seizures in the setting of vasogenic edema on brain imaging, which is often localized to the posterior white matter. The symptoms are classically triggered by severe hypertension, pregnancy and the puerperium, or exposure to immunosuppressive medications. The symptoms can be reversible if the offending etiology is quickly removed, but permanent deficits can remain if strokes or hemorrhage complicate the clinical course.

scholarly journals Posterior reversible encephalopathy syndrome (PRES) with obstructive hydrocephalus

2017 ◽  
Vol 98 (10) ◽  
pp. 745-746 ◽  
Author(s):  
P. Naval Baudin ◽  
T. Martínez Fernández ◽  
P. Mora ◽  
A. Corrales Cruz ◽  
J.C. Sardiñas Barrero ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Obstructive Hydrocephalus ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome during posterior fossa tumor resection in a child

2010 ◽  
Vol 6 (4) ◽  
pp. 377-380 ◽  
Author(s):  
Akash J. Patel ◽  
Benjamin D. Fox ◽  
Daniel H. Fulkerson ◽  
Sasidhar Yallampalli ◽  
Anna Illner ◽  
...  
Keyword(s):  
Posterior Fossa ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Severe Hypertension ◽  
Single Case ◽  
Tumor Resection ◽  
Posterior Fossa Tumor ◽  
Lower Cranial Nerve ◽  
Posterior Reversible Encephalopathy ◽  
Cranial Nerve Dysfunction ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) has been described in the setting of malignant hypertension, renal disease, eclampsia, and immunosuppression. In addition, a single case of intraoperative (posterior fossa craniotomy) PRES has been reported; however, this case occurred in an adult. The authors present a clinically and radiographically documented case of intraoperative PRES complicating the resection of a posterior fossa tumor in a 6-year-old child. During tumor resection, untoward force was used to circumferentially dissect the tumor, and excessive manipulation of the brainstem led to severe hypertension for a 10-minute period. An immediate postoperative MR image was obtained to rule out residual tumor, but instead the image showed findings consistent with PRES. Moreover, the patient's postoperative clinical findings were consistent with PRES. Aggressive postoperative management of blood pressure and the institution of anticonvulsant therapy were undertaken. The patient made a good recovery; however, he required a temporary tracheostomy and tube feedings for prolonged lower cranial nerve dysfunction. Posterior reversible encephalopathy syndrome can occur as a result of severe hypertension during surgery, even among young children. With prompt treatment, the patient in the featured case experienced significant clinical and radiographic recovery.

scholarly journals Posterior Reversible Encephalopathy Syndrome and Azathioprine

2019 ◽  
Author(s):  
Sara Pinto Teixeira Vilas-Boas ◽  
Ana Corte-Real
Keyword(s):  
Magnetic Resonance Imaging ◽  
Status Epilepticus ◽  
White Matter ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Severe Hypertension ◽  
Neurological Manifestations ◽  
Resonance Imaging ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a rare syndrome that presents with neurological manifestations, often associated with arterial hypertension. Magnetic resonance imaging (MRI) shows bilateral white matter oedema in the posterior vascular territories. Immunosuppression, (pre) eclampsia and autoimmune diseases can be implicated. A 27-year-old woman, with mixed connective tissue disease under azathioprine, was admitted in the emergency room in status epilepticus and with severe hypertension. The MRI showed bilateral oedema in a pattern compatible with PRES. There was clinical improvement after azathioprine suspension. PRES is typically reversible with prompt recognition of the syndrome and its trigger. The association with azathioprine is rare.

scholarly journals Posterior Reversible Encephalopathy Syndrome associated with Obstructive Hydrocephalus : A Case Report

2012 ◽  
Vol 21 (5) ◽  
pp. 421-425
Author(s):  
Tadashi Sunohara ◽  
Kentaro Fumoto ◽  
Kouichiro Shindo ◽  
Taku Asanome ◽  
Joji Nakagawara ◽  
...  
Keyword(s):  
Case Report ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Obstructive Hydrocephalus ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

scholarly journals Posterior Reversible Encephalopathy Syndrome due to Eclampsia in Term Pregnancy

2015 ◽  
Vol 10 (1) ◽  
pp. 69-72
Author(s):  
T Gurung ◽  
AB Shrestha ◽  
S Shrestha
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Severe Hypertension ◽  
Cranial Computed Tomography ◽  
Supportive Treatment ◽  
Foetal Death ◽  
Term Pregnancy ◽  
Posterior Reversible Encephalopathy ◽  
The Third ◽  
Parietal Lobes ◽  
Reversible Encephalopathy

We report a 30 years primigravidae presented in term pregnancy with eclampsia with intrauterine foetal death and underwent instrumental delivery. Peripartum management of eclampsia is always challenging for anaesthesiologist and obstretrician. The case was managed under general anaesthesia and kept on mechanical ventilation for three days. Postpartum cranial computed tomography revealed low attenuated area in right basal ganglia. Low attenuated area in bilateral frontal and parietal lobes with subtle gyral high density in bilateral frontal lobes. Report was suggestive of posterior reversible encephalopathy syndrome. Clinical improvement was observed with supportive treatment and extubated on the third postpartum day. Posterior reversible encephalopathy syndrome is a cliniconeuroradiological syndrome associated with the various conditions including severe hypertension and seizures. Eclampsia is one of the most important causes of posterior reversible encephalopathy syndrome.

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