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

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 Eclampsia-Induced Posterior Reversible Encephalopathy Syndrome in a Donor Oocyte Recipient

2021 ◽  
Author(s):  
Jesús Garcia Castro ◽  
Jorge Rodríguez-Pardo ◽  
Javier Díaz de Terán
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Illustrative Case ◽  
Posterior Reversible Encephalopathy ◽  
Donor Oocyte ◽  
Oocyte Fertilization ◽  
Emergency Cesarean ◽  
Hypertensive Disorders In Pregnancy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Objective: Posterior reversible encephalopathy syndrome (PRES) has been robustly associated with preeclampsia, hyperperfusion or endothelial dysfunction suggested as possible mechanisms. In this article, we report an illustrative case of this complication in a patient with risk factors for hypertensive disorders in pregnancy, including advanced maternal age and donor oocyte fertilization. Case report: We present a case of a 40-year-old pregnant, donor oocyte recipient with sudden decreased visual acuity accompanied by hypertension, proteinuria and tonic-clonic seizures. Magnetic resonance imaging (MRI) of the brain showed bilateral lesions in the parieto-occipital regions suggestive of vasogenic edema, leading us to suspect posterior reversible encephalopathy syndrome. The patient underwent an emergency cesarean section and labetalol and magnesium sulfate were administered intravenously. The neurological symptoms and radiological findings resolved following delivery and the patient’s blood pressure normalized, supporting the diagnosis of posterior reversible encephalopathy syndrome. Conclusion: Pregnancy by donor oocyte fertilization may entail a higher risk of eclampsia and associated posterior reversible encephalopathy syndrome.  

scholarly journals Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndrome

2015 ◽  
Vol 73 (1) ◽  
pp. 36-40 ◽  
Author(s):  
P Ricardo Pereira ◽  
João Pinho ◽  
Margarida Rodrigues ◽  
João Rocha ◽  
Filipa Sousa ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Brain Regions ◽  
Autonomic Dysreflexia ◽  
Posterior Reversible Encephalopathy ◽  
The North ◽  
Etiological Spectrum ◽  
Life Threatening ◽  
Reversible Encephalopathy ◽  
Frontal Lesions

ObjectiveAnalyze the cases of posterior reversible encephalopathy syndrome (PRES) admitted in a Neurology Department during an 8-year period.MethodRetrospective observational study in a central hospital in the north of Portugal.Results14 patients were identified, mean age 52.3 years. Precipitating factors included: eclampsia, isolated arterial hypertension, spinal trauma and autonomic dysreflexia, Guillain-Barré syndrome, sepsis, sarcoidosis and pulmonary cryptococcosis and drugs. Most patients presented posterior-predominant vasogenic edema lesions, however 64.2% presented frontal lesions and in 42.8% cerebellum was involved. Four patients also had acute ischemic lesions and 1 had hemorrhagic lesions. During follow-up 10 patients recovered fully, 2 recovered partially, 1 suffered a recurrence and 2 died in hospital.ConclusionPRES has many etiological factors. The terms posterior and reversible should be revised because PRES frequently involves other brain regions and it is not always reversible. PRES patients may develop life-threatening complications and mortality is not negligible.

Posterior reversible encephalopathy syndrome (PRES): presentation, diagnosis and treatment

2020 ◽  
Vol 96 (1140) ◽  
pp. 623-628 ◽  
Author(s):  
Anant Parasher ◽  
Rajat Jhamb
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Positive Outcome ◽  
Neurological Deficits ◽  
Posterior Reversible Encephalopathy ◽  
Mri Scans ◽  
Blood Pressures ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder which is characterised by variable symptoms, which include visual disturbances, headache, vomiting, seizures and altered consciousness. The exact pathophysiology of PRES has not been completely explained, but hypertension and endothelial injury seem to be almost always present. Vasoconstriction resulting in vasogenic and cytotoxic edema is suspected to be responsible for the clinical symptoms as well as the neuro-radiological presentation. On imaging studies, Symmetrical white matter abnormalities suggestive of edema are seen in the computer tomography (CT) and magnetic resonance imaging (MRI) scans, commonly but not exclusively in the posterior parieto-occipital regions of the cerebral hemispheres. The management is chiefly concerned with stabilization of the patient, adequate and prompt control of blood pressure, prevention of seizures and timely caesarean section in obstetric cases with pre-eclampsia/eclampsia. In conclusion, persistently elevated blood pressures remain the chief culprit for the clinical symptoms as well as the neurological deficits. Early diagnosis by diffusion weighted MRI scans, and differentiation from other causes of altered sensorium i.e. seizures, meningitis and psychosis, is extremely important to initiate treatment and prevent further complications. Although most cases resolve successfully and carry a favorable prognosis, patients with inadequate therapeutic support or delay in treatment may not project a positive outcome.

scholarly journals Good outcome after posterior reversible encephalopathy syndrome (PRES) despite elevated cerebral lactate: a case report

2015 ◽  
Vol 4 (6) ◽  
pp. 205846011557832 ◽  
Author(s):  
Caroline Ewertsen ◽  
Daniel Kondziella ◽  
Else R Danielsen ◽  
Carsten Thomsen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Resonance Imaging ◽  
Posterior Reversible Encephalopathy ◽  
Irreversible Brain Damage ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
The Brain ◽  
Elevated Lactate

Posterior reversible encephalopathy syndrome (PRES) may cause irreversible brain damage. The diagnosis is confirmed by magnetic resonance imaging (MRI), where vasogenic edema may be seen especially in the posterior parts of the brain. MR spectroscopy (MRS) may be included to help predict the outcome by measuring selected metabolites for instance lactate. Usually lactate is immeasurable in brain tissue, but elevates in cases of hypoxia, and it has been associated with poor outcome. We report a case of a patient with eclampsia and PRES, who had elevated lactate initially, but complete remission clinically and on MRI.

scholarly journals Posterior reversible encephalopathy syndrome and pregnancy: a Moroccan retrospective study of a patient’s oligo series

2021 ◽  
Vol 10 (10) ◽  
pp. 3942
Author(s):  
Aboubakr Benjilany ◽  
Jaouad Kouach
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Military Hospital ◽  
Lung Edema ◽  
Posterior Reversible Encephalopathy ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
The Military ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is an entity combining reversible central nervous system damages with characteristic magnetic resonance imaging (MRI) brain imaging, it can occur in peripartum regardless of any preexisting pathology. PRES in peripartum is a poorly understood phenomenon. Early diagnosis and management are essential to prevent irreversible neurological sequelae. We report 6 cases series of PRES, collected at obstetrics and gynecology department of the military hospital Mohamed V in Rabat, between 2000 and 2019, in order to describe and analyze epidemiological, clinical, paraclinical and therapeutic aspects. Average age was 27 years old. Found symptoms were: high blood pressure, seizures, headaches, visual disturbances, consciousness disorders, vivid osteotendinous reflexes, vertigo, nausea and vomiting. Associated complications were status epilepticus, eclampsia, haemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome and acute lung edema. Radiologically, found lesions are suggestive of PRES. After management, evolution was favorable in all patients. 

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 Posterior reversible encephalopathy syndrome in an AIDS patient with acute renal failure and hypertension

2013 ◽  
pp. 190-193
Author(s):  
Olivia Bargiacchi ◽  
Anna M. Salerno ◽  
Antonella Rossati ◽  
Roberta Brondolo ◽  
Diego Brustia ◽  
...  
Keyword(s):  
Renal Failure ◽  
Acute Renal Failure ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Antihypertensive Agents ◽  
Endothelial Damage ◽  
Mri Findings ◽  
Predisposing Factor ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Introduction: The posterior reversible encephalopathy syndrome (PRES) is a neurological entity characterized by magnetic resonance imaging (MRI) evidence of bilateral subcortical edema in the occipital regions of the brain. Case report: We report the case of a female patient with AIDS, pulmonary aspergillosis, CMV infection, and acute renal failure due to Clostridium difficile diarrhea. Her clinical course was complicated by seizures and hypertension. MRI findings were consistent with PRES. The patient was treated with anticonvulsants and antihypertensive agents with clinical improvement. Discussion and conclusions: Few cases of PRES in HIV-infected patients have been described, and it is not clear whether HIV infection is a predisposing factor for this syndrome. The article reviews the literature on PRES in HIV and discusses the role of HIV-associated endothelial damage in the pathogenesis of this syndrome.

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.

Sign in / Sign up

Export Citation Format

Share Document