scholarly journals Posterior Reversible Encephalopathy Syndrome (PRES): A case series in postpartum patients

2013 ◽  
Vol 1 (2) ◽  
pp. 104-106
Author(s):  
Rama Biswas ◽  
Shahzadi Sayeeda Tun Nessa ◽  
Poly Sen Gupta ◽  
Shokhina Biswas
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Case Series ◽  
Supportive Treatment ◽  
Radiological Findings ◽  
Mri Scan ◽  
Posterior Reversible Encephalopathy ◽  
Characteristic Features ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) refers to a clinicoradiologic entity with characteristic features on neuroimaging and nonspecific symptoms comprising headache, confusion, visual disturbances and seizures. The radiological findings in PRES are thought to be due to vasogenic edema, predominantly in the posterior cerebral hemispheres and are reversible with appropriate management.We report 4 cases of PRES diagnosed by MRI scan following uneventful caesarean section in previously normotensive patients who were succesfully treated with antihypertensives, anticonvulsants and supportive treatment. DOI: http://dx.doi.org/10.3329/bccj.v1i2.17205 Bangladesh Crit Care J September 2013; 1 (2): 104-106

scholarly journals Postpartum Posterior Reversible Encephalopathy Syndrome – A Case that can Press Hard an Obstetrician

2017 ◽  
Vol 31 (1) ◽  
pp. 46-49
Author(s):  
Fahmida Rashid ◽  
Md Abdus Sattar
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Hypertensive Encephalopathy ◽  
Mri Findings ◽  
Posterior Reversible Encephalopathy ◽  
Life Threatening ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Prompt Diagnosis ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is a recently described clinicoradiologic entity that is associated with several medical conditions like hypertensive encephalopathy and eclampsia. It present with headache, confusion, visual disturbances or blindness, and seizures. Parieto-occipital white matter changes due to vasogenic edema can be observed on imaging modalities. It rarely occurs without seizures. There have been reports about PRES associated with pregnancy, especially peripartum. It is often, but not always, associated with high blood pressure. The pathophysiology of PRES is not still clear. Here we report a 23-yearold primigravida with unremarkable antenatal period but complicated by PRES with seizures at her 5th postpartum day. Postictal findings reported headache and magnetic resonance imaging (MRI) findings suggested that PRES were evident. Clinical improvement with complete resolution without any complications was observed on the 8th post operative day with supportive treatment. This case report highlights the importance of awareness, prompt diagnosis and treatment to improve the outcome in this potentially life-threatening, but reversible condition.Bangladesh J Obstet Gynaecol, 2016; Vol. 31(1) : 46-49

scholarly journals Posterior Reversible Encephalopathy Syndrome as a Postpartum Complication

2018 ◽  
Vol 6 (5) ◽  
pp. 851-854
Author(s):  
Samra Kadić-Vukas ◽  
Mirsada Hodžić ◽  
Lejla Tandir-Lihić ◽  
Lejla Hrvat ◽  
Azra Kožo-Kajmaković ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Delayed Diagnosis ◽  
Case Series ◽  
Epileptic Seizures ◽  
Posterior Reversible Encephalopathy ◽  
Endotracheal Anaesthesia ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
The Brain ◽  
Visual Disturbances

BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome with seizures, altered consciousness, visual disturbances and headache among other symptoms. Hinchey et al. first described Pres in 1996, with two other case series published shortly after.CASE REPORT: A 23-year-old women patient was emergency sent from General Hospital Tešanj due to a crisis of consciousness and repeated epileptic seizures. The patient had a second birth before 10 days (postpartum cesarean) in general endotracheal anaesthesia (two cesarean-born babies). On magnetic resonance imaging (MRI) of cranium described both sides of the symmetrically frontal, parietal (and pre-ventricular gyri) and occipitally visible T2W/FLAIR hyperintensity focuses on the cortex and the thin layer of white mass subcortically. In the projection of the lesions parts, discrete DWI hyperintensity is seen without a reliable ADC correlate. The patient improved after management with intravenous fluids, antibiotics, antiepileptics and monitoring of blood pressure. According to latest experiences delayed diagnosis and treatment may lead to mortality or irreversible neurological deficit. Aggravating circumstances are differential diagnoses that include cerebral infarction (ischemic, haemorrhage), venous thrombosis, vasculitis, pontine or extrapontine myelinolysis.CONCLUSION: MRI of the brain is key to make this distinction with crucial recognition and an open mind from radiology and neurology specialist.

Posterior Reversible Encepalopathy Syndrome in A Child With Post Streptococcal Glomerulonephritis- A Rare Case Report

Med Phoenix ◽  
2021 ◽  
Vol 6 (1) ◽  
pp. 50-52
Author(s):  
Sunita Ghimire ◽  
Shree Krishna Shrestha ◽  
Ram Chandra Bastola ◽  
Anita Dahal ◽  
Pragya Shakya
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Female Child ◽  
Hypertensive Encephalopathy ◽  
Posterior Reversible Encephalopathy ◽  
Radiological Features ◽  
Rare Case Report ◽  
Post Streptococcal Glomerulonephritis ◽  
Reversible Encephalopathy ◽  
Timely Treatment

Posterior reversible encephalopathy syndrome is a condition occurring  in majority of case of  hypertensive encephalopathy mainly due to vasogenic  edema in parieto occipital region in neuroimaging. It is reversible if timely treatment is done .Here we are reporting a 11 year old female child with acute post streptococal glomerulonephrtitis leading to typical clinical and radiological features of posterior reversible encephalopathy syndrome

scholarly journals A broad spectrum of posterior reversible encephalopathy syndrome - a case series with clinical and paraclinical characterisation, and histopathological findings

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fatme Seval Ismail ◽  
Johannes van de Nes ◽  
Ilka Kleffner
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Brain Mri ◽  
Case Series ◽  
Epileptic Seizures ◽  
Retrospective Case ◽  
Posterior Reversible Encephalopathy ◽  
Histopathological Findings ◽  
Delay In Diagnosis ◽  
Reversible Encephalopathy

Abstract Background Posterior reversible encephalopathy syndrome (PRES) is clinical-neuroradiologically defined and potentially reversible, so there are limited data about histopathological findings. We aimed to describe the clinical and paraclinical features of patients with PRES with regard to its reversibility. Methods This retrospective case series encompasses 15 PRES cases out of 1300 evaluated patients from a single German center between January 1, 2010, and June 15, 2020. PRES was established according to the diagnostic criteria as proposed by the Berlin PRES Study 2012. One of the cases studied was subject to brain autopsy. Results From the 15 patients studied (median age 53 years, range 17–73; 11 female), 67 % presented with epileptic seizures, 40 % suffered from encephalopathy with reduced consciousness and 53 % developed delirium, while 47 % had headache and visual disturbances. Subcortical brain MRI abnormalities related to PRES were observed in all patients. One patient developed spinal ischemia and another Guillain-Barré syndrome in addition to PRES. Hypertensive blood pressure was the main underlying/trigger condition in all patients. Clinical symptoms and MRI changes were not reversible in 42 %, even progressive in 3 out of these 5 patients. Median time from symptom onset to diagnosis in these non-reversible cases was 7 days (range 0–13), while the median delay in diagnosis in the reversible group was 1 day (range 0–3). Cerebellar/brain stem involvement and status epilepticus were more frequently in patients with non-reversible disease course. Mortality due to PRES occurred in 13 % of these patients. Neuropathological examination of the brain of a 57-year-old female patient revealed major leukencephalopathic changes, fibrinoid necrosis of endothelial cells and fresh petechial hemorrhages in accordance with PRES. Conclusions Our case series demonstrates that PRES was not reversible in 42 % of the studied patients. Delay in diagnosis seems to contribute to limited reversibility and poor outcome.

scholarly journals Transient increase of fractional anisotropy in reversible vasogenic edema

2016 ◽  
Vol 36 (10) ◽  
pp. 1731-1743 ◽  
Author(s):  
Shihoko Kimura-Ohba ◽  
Yi Yang ◽  
Jeffrey Thompson ◽  
Tomonori Kimura ◽  
Victor M Salayandia ◽  
...  
Keyword(s):  
Fractional Anisotropy ◽  
Acute Phase ◽  
Cyclosporine A ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Pathological Condition ◽  
Neurological Diseases ◽  
Vasogenic Edema ◽  
High Dose ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy

Brain vasogenic edema, involving disruption of the blood-brain barrier, is a common pathological condition in several neurological diseases, with a heterogeneous prognosis. It is sometimes reversible, as in posterior reversible encephalopathy syndrome, but often irreversible and our current clinical tools are insufficient to reveal its reversibility. Here, we show that increased fractional anisotropy in magnetic resonance imaging is associated with the reversibility of vasogenic edema. Spontaneously, hypertensive rats-stroke prone demonstrated posterior reversible encephalopathy syndrome-like acute encephalopathy in response to high-dose cyclosporine A treatment; the deteriorating neurological symptoms and worsening scores in behavioral tests, which were seen in acute phase, dissappered after recovery by cessation of cyclosporine A. In the acute phase of encephalopathy, the fractional anisotropy and apparent diffusion coefficient increased in areas with IgG leakage. This increase of fractional anisotropy occurred in the absence of demyelination: fluid leakage into the myelinated space increased the axial, but not the radial, diffusivity, resulting in the increased fractional anisotropy. This increased fractional anisotropy returned to pre-encephalopathy values in the recovery phase. Our results highlight the importance of the fractional anisotropy increase as a marker for the reversibility of brain edema, which can delineate the brain areas for which recovery is possible.

Posterior Reversible Encephalopathy Syndrome (PRES) in Palliative Medicine: Case Report and Discussion

2021 ◽  
pp. 104990912110304
Author(s):  
Jade Willey ◽  
Steven J. Baumrucker
Keyword(s):  
Case Report ◽  
Mental Status ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Palliative Medicine ◽  
Altered Mental Status ◽  
Posterior Reversible Encephalopathy ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is associated with seizures, visual disturbances, headache, and altered mental status. Given its presentation, the diagnosis can be mistaken for other severe conditions. Palliative medicine consultants should be aware of PRES and be prepared to counsel families on the treatment and prognosis of this syndrome.

Posterior reversible encephalopathy syndrome (PRES) presenting as Status Epilepticus in a case of Autoimmune Hemolytic Anemia (AIHA): A Case report

2021 ◽  
Vol 12 (6) ◽  
pp. 102-106
Author(s):  
Sameera Dronamraju ◽  
Shilpa Gaidhane ◽  
Aayush Somani ◽  
Sourya Acharya
Keyword(s):  
Status Epilepticus ◽  
Hemolytic Anemia ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Autoimmune Hemolytic Anemia ◽  
Vasogenic Edema ◽  
Complete Recovery ◽  
Young Female ◽  
Posterior Reversible Encephalopathy ◽  
Oral Steroids ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state, caused by imbalance in autoregulation of posterior cerebral circulation. We report a case of young female, presented at emergency department with complains of nausea, vomiting and generalized tonic clonic seizures prior to admission. During the course of hospital stay patient landed in status epilepticus which was treated appropriately. Patient’s magnetic resonance imaging (MRI) was done which had classical features of vasogenic edema in occipital and parietal region, suggestive of PRES. She was a known case of autoimmune hemolytic anemia thatwas treated with multiple blood transfusions and low dose oral steroids. She was discharged after complete resolution of symptoms with the advice to follow up in medicine outpatient department. Our case describes about autoimmune hemolytic anemia in which occurrence of PRES is uncommon. Early diagnosis and robust treatment can prevent permanent damage to the brain, and is often associated with complete recovery.

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

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