Het posterieur reversibel encefalopathiesyndroom

Complete Recovery ◽

Underlying Disease ◽

Vasogenic Oedema ◽

Immunosuppressive Medication ◽

Failure Treatment ◽

Wide Range ◽

The Brain

Posterior reversible encephalopathy syndrome Being confronted with postoperative complications can be challenging. When a patient shows signs of postoperative neurological deficit, a wide range of possible explanations has to be considered. In this specific case, the diagnosis of posterior reversible encephalopathy syndrome (PRES) was made. PRES is characterised by neurological symptoms (headache, confusion, visual changes, paresis and/or convulsions) and certain findings on cerebral imaging (vasogenic oedema, predominantly in the posterior areas of the brain). It is linked to hypertensive disorders, (pre-)eclampsia, certain auto-immune diseases, the use of immunosuppressive medication and kidney failure. Treatment of the hypertension is crucial, but antiseizure drugs and treatment of the underlying disease may also be necessary. Most patients have a complete recovery within 2 weeks. A small minority, however, experiences residual neurologic deficits resulting from secondary cerebral infarction or haemorrhage.

Posterior reversible encephalopathy syndrome: A case report

Vojnosanitetski pregled ◽

10.2298/vsp140529053k ◽

2015 ◽

Vol 72 (8) ◽

pp. 735-739

Author(s):

Dejan Kostic ◽

Biljana Brkic-Georgievski ◽

Aleksandar Jovanovski ◽

Smiljana Kostic ◽

Drazen Ivetic ◽

...

Keyword(s):

Case Report ◽

White Matter ◽

Impaired Consciousness ◽

Neurological Signs ◽

Appropriate Treatment ◽

History Of ◽

The Brain

Posterior reversible encephalopathy syndrome (PRES) is characterized by the following symptoms: seizures, impaired consciousness and/or vision, vomiting, nausea, and focal neurological signs. Diagnostic imaging includes examination by magnetic resonance (MR) and computed tomography (CT), where brain edema is visualized bi-laterally and symmetrically, predominantly posteriorly, parietally, and occipitally. Case report. We presented a 73-year-old patient with the years-long medical history of hipertension and renal insufficiency, who developed PRES with the symptomatology of the rear cranium. CT and MR verified changes in the white matter involving all lobes on both sides of the brain. After a two-week treatment (antihypertensive, hypolipemic and rehydration therapy) clinical improvement with no complications occurred, with complete resolution of changes in the white matter observed on CT and MR. Conclusion. PRES is a reversible syndrome in which the symptoms withdraw after several days to several weeks if early diagnosis is made and appropriate treatment started without delay.

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

Asian Journal of Medical Sciences ◽

10.3126/ajms.v12i6.33817 ◽

2021 ◽

Vol 12 (6) ◽

pp. 102-106

Author(s):

Sameera Dronamraju ◽

Shilpa Gaidhane ◽

Aayush Somani ◽

Sourya Acharya

Keyword(s):

Status Epilepticus ◽

Hemolytic Anemia ◽

Autoimmune Hemolytic Anemia ◽

Vasogenic Edema ◽

Complete Recovery ◽

Young Female ◽

Oral Steroids ◽

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.

Optic pathways and brainstem involvement in posterior reversible encephalopathy syndrome

BMJ Case Reports ◽

10.1136/bcr-2020-239130 ◽

2021 ◽

Vol 14 (1) ◽

pp. e239130

Author(s):

Sofia Grenho Rodrigues ◽

Paulo Saraiva ◽

Inês Brás Marques

Keyword(s):

Brain Mri ◽

Vasogenic Oedema ◽

Ischaemic Optic Neuropathy ◽

Complete Reversal ◽

Optic Pathways ◽

The Right ◽

Persistent Headache ◽

Posterior reversible encephalopathy syndrome (PRES) is a neurological syndrome manifesting with acute focal signs, and concomitant neuroimaging findings of vasogenic oedema. It affects the parieto-occipital regions in a vast majority of cases, although atypical variants have been described comprising the brainstem, basal ganglia or spinal cord. We report the case of a 41-year-old woman, admitted for persistent headache and inferior altitudinal field defect in the right eye. She presented with severe, non-medicated, hypertension. Brain MRI showed findings compatible with atypical PRES, involving the brainstem and optic pathways. With antihypertensive therapy the headache remitted, although visual field remained and was interpreted in the context of a vascular aetiology—non-arteritic anterior ischaemic optic neuropathy. MRI was repeated 3 weeks later and showed almost complete reversal of the previous changes.

Posterior Reversible Encephalopathy Syndrome in a Postpartum Preeclamptic Woman without Seizure

Case Reports in Obstetrics and Gynecology ◽

10.1155/2014/657903 ◽

2014 ◽

Vol 2014 ◽

pp. 1-3

Author(s):

Ülkü Mete Ural ◽

Gülsah Balik ◽

Şenol Şentürk ◽

Işık Üstüner ◽

Uğur Çobanoğlu ◽

...

Keyword(s):

Complete Resolution ◽

Term Pregnancy ◽

Vasogenic Oedema ◽

White Matter Changes ◽

Appropriate Treatment ◽

History Of ◽

Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is a cliniconeuroradiological entity presenting with headache, confusion, visual disturbances or blindness, and seizures. Parieto-occipital white matter changes due to vasogenic oedema can be observed on imaging modalities. It rarely occurs without seizures and after delivery. We report a 33-year-old multigravida with a history of preeclampsia in term pregnancy complicated by PRES without seizures at the postpartum period. Clinical improvement with complete resolution without any complications was observed on the 6th day after delivery. Posterior reversible encephalopathy syndrome is reversible when early diagnosis is established and appropriate treatment is started without delay.

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

Acta Radiologica Open ◽

10.1177/2058460115578324 ◽

2015 ◽

Vol 4 (6) ◽

pp. 205846011557832 ◽

Cited By ~ 1

Author(s):

Caroline Ewertsen ◽

Daniel Kondziella ◽

Else R Danielsen ◽

Carsten Thomsen

Keyword(s):

Magnetic Resonance Imaging ◽

Vasogenic Edema ◽

Resonance Imaging ◽

Irreversible Brain Damage ◽

Magnetic Resonance Imaging Mri ◽

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.

Posterior Reversible Encephalopathy Syndrome (PRES) Associated With COVID-19 Infection—A Case Report and Review

Journal of Stroke Medicine ◽

10.1177/25166085211069861 ◽

2022 ◽

pp. 251660852110698

Author(s):

Shamik Shah ◽

Urvish Patel ◽

Neev Mehta ◽

Pratik Shingru

Keyword(s):

Neurological Complication ◽

Respiratory Illness ◽

Altered Mental Status ◽

Neurological Complications ◽

Idiopathic Epilepsy ◽

Systemic Complications ◽

Wide Range ◽

Coronavirus disease 2019 (COVID-19) has caused a large number of systemic complications including a variety of neurological complications. Some of the neurological complications are not known. Posterior reversible encephalopathy syndrome (PRES) is a known acute neurotoxic syndrome causing a wide range of neurological symptoms. If remains untreated, it can potentially become a life-threatening condition. However, it is not a known neurological complication of COVID-19. We describe a presentation of PRES in a patient with positive COVID-19 and presented with altered mental status. A 78-year-old male with history of idiopathic epilepsy was initially admitted with respiratory illness with negative COVID-19 test. Later during his hospitalization, his respiratory condition got worse and his repeat COVID-19 test came back positive. He had continued encephalopathy and was found to have status epilepticus afterward. Magnetic Resonance Imaging brain showed extensive PRES-related changes. His blood pressure remained overall within control without significant fluctuations. No other apparent etiology was identified for PRES except for possible correlation with COVID-19. Clinicians should consider PRES early in their differential diagnoses in patients with severe COVID-19 with continued encephalopathy.

MANAGEMENT OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME IN AN UNBOOKED TERM PREGNANT CASE WITH ECLAMPSIA.

10.36106/ijsr/1034756 ◽

2020 ◽

pp. 1-3

Author(s):

Sunny Aggarwal ◽

Priyanka dev ◽

Sagar Mazumder

Keyword(s):

Blood Pressure ◽

Gold Standard ◽

Complete Resolution ◽

Seizure Control ◽

Vasogenic Oedema ◽

White Matter Changes ◽

Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) usually presents with headache, confusion, visual disturbances or blindness and seizures. MRI is gold standard with parieto-occipital white matter changes due to vasogenic oedema in most of the cases. We report a 20-year-old unbooked primigravida with eclampsia prior to delivery which got complicated by PRES after delivery on day 1 postpartum. General anesthesia was given for caesarean section and post operatively patient was managed in ICU with strict blood pressure and seizure control. Clinical improvement with complete resolution without any complications was observed on the day 10 postpartum.

Sudden Bilateral Choroidal Detachment in a Patient with Posterior Reversible Encephalopathy Syndrome

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2014.087 ◽

2014 ◽

Vol 2 (3) ◽

pp. 488-490

Author(s):

Jasna Pavicic-Astalos ◽

Zoran Vatavuk ◽

Goran Bencic ◽

Biljana Andrijevic-Derk ◽

Krunoslav Kuna

Keyword(s):

Correct Diagnosis ◽

Altered Mental Status ◽

Postnatal Period ◽

Neurological Deficits ◽

Vascular Changes ◽

The Brain ◽

Visual Disturbances

BACKGROUND: Pre-eclampsia is one of the most important causes of a rare cliniconeuroradiological entity called posterior reversible encephalopathy syndrome. The syndrome is characterized by headacke, visual disturbances, seizures, altered mental status and radiological findings of edema in the white matter of the brain areas perfused by the posterior brain circulation.CASE REPORT: Here we present a patient with sudden bilateral visual loss and deafness in early postnatal period without any other neurological deficits, but with affiliated ophthalmological pathology. The correct diagnosis was made 3 days after the Cesarean section.The patient was diagnosed with posterior reversible encephalopathy syndrome and bilateral choroidal detachment.CONCLUSION: Vascular changes in posterior reversible encephalopathy syndrome can cause visual disturbances not only by brain edema, but combined brain and ocular pathology.

Complete Neurological Recovery In A 3 Year Old Presenting With Posterior Reversible Encephalopathy Syndrome Due To Idiopathic Hypertension – A Case Report

YMER Digital ◽

10.37896/ymer21.01/05 ◽

2022 ◽

Vol 21 (01) ◽

pp. 56-62

Author(s):

Dr. Nandita Bhalla ◽

◽

Dr. Shrikiran Aroor ◽

Keyword(s):

Clinical Symptoms ◽

Case Reports ◽

Hypertensive Crisis ◽

Neurological Recovery ◽

Symptomatic Therapy ◽

Mri Findings ◽

Vasogenic Oedema ◽

Posterior reversible encephalopathy syndrome is an acute neurological illness presenting with clinical symptoms and distinctive MRI findings. Symptoms include headaches, seizures, altered consciousness as well as visual impairment. PRES is always accompanied by peculiar radiological findings of edematous change affecting the rear cerebral area. It commonly occurs in settings where patients are undergoing hypertensive crisis, or there is the use of steroids, calcineurin inhibitors, in the nephritic state or end-stage renal disease. The management includes treating the underlying cause and symptomatic therapy. However, due to relatively fewer pediatric reports, its management isn’t specific and rather based on experience. Our patient is a 3-year-old male, who presented with hypertensive crisis and MRI findings confirmed it to be a case of PRES. He was managed with a combined regime of antihypertensive and steroids which lead to complete neurological recovery and resolution of PRES. There are a scarce number of case reports on the use of steroids for the treatment of vasogenic oedema in children.

Posterior Reversible Encephalopathy Syndrome

The Neurohospitalist ◽

10.1177/1941874416665762 ◽

2016 ◽

Vol 7 (1) ◽

pp. 24-29 ◽

Cited By ~ 4

Author(s):

Hussein Algahtani ◽

Abdulhadi Algahtani ◽

Ahmad Aldarmahi ◽

Mohammed Hmoud ◽

Yousef Marzuk ◽

...

Keyword(s):

Saudi Arabia ◽

Clinical Signs ◽

Complete Recovery ◽

High Risk Group ◽

Imaging Features ◽

Altered Level ◽

Benign Condition ◽

Objectives: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome characterized by headache, altered mental status, seizures, or loss of vision. In this study, we report the largest series of PRES coming from Saudi Arabia and explore the etiology, clinical presentation, and outcome. We also report new imaging findings associated with this condition. Methods: We performed a retrospective study of all cases of PRES admitted to King Abdulaziz Medical City, Jeddah, Saudi Arabia, between the years 2005 and 2015. A neurologist reviewed all charts and analyzed the clinical presentations, etiological factors, and outcomes, and a neuroradiologist reviewed the imaging studies. Only patients with clinical and imaging features consistent with PRES were included in the study. Results: We collected 31 patients who had clinical and radiological features consistent with PRES. Females were more affected than males (18 females and 13 males), and patients’ age ranged from 6 to 95 years, with a mean of 38.3 years. Patients were treated by removing the precipitating causes and treating the underlying conditions. Resolution of neurologic signs occurred within 2 to 3 weeks in all patients. Conclusion: In our opinion, PRES itself is usually a benign condition with complete recovery if the condition is recognized early and managed appropriately. Although clinical signs are nonspecific, the constellation of symptoms including headache, visual problems, seizures, and altered level of consciousness should suggest the possibility of PRES, especially in high-risk group. Abnormalities on magnetic resonance imaging are often characteristic and may be the first clue to the diagnosis.