Pressurized Contrast‐Related Posterior Reversible Encephalopathy Syndrome After Cerebral Digital Subtraction Angiography
Posterior reversible encephalopathy syndrome is a multifactorial neurological disorder characterized by clinical and neuroimaging findings. The “vasogenic theory” suggests that, in this condition, disrupted cerebrovascular autoregulation leads to blood‐brain barrier failure and vasogenic edema. Post...
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Wiley
2025-05-01
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| Series: | Stroke: Vascular and Interventional Neurology |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/SVIN.124.001362 |
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| author | Lea Scherschinski Tyler D. Schriber Stefan W. Koester Adam T. Eberle Joshua S. Catapano Ethan A. Winkler Felipe C. Albuquerque Michael T. Lawton Andrew F. Ducruet Ruchira M. Jha Ashutosh P. Jadhav |
| author_facet | Lea Scherschinski Tyler D. Schriber Stefan W. Koester Adam T. Eberle Joshua S. Catapano Ethan A. Winkler Felipe C. Albuquerque Michael T. Lawton Andrew F. Ducruet Ruchira M. Jha Ashutosh P. Jadhav |
| author_sort | Lea Scherschinski |
| collection | DOAJ |
| description | Posterior reversible encephalopathy syndrome is a multifactorial neurological disorder characterized by clinical and neuroimaging findings. The “vasogenic theory” suggests that, in this condition, disrupted cerebrovascular autoregulation leads to blood‐brain barrier failure and vasogenic edema. Posterior reversible encephalopathy syndrome is commonly associated with hypertension, chemotherapy, and transplantation, but neurosurgical patients, including those undergoing digital subtraction angiography, are also at elevated risk. A patient with a history of traumatic brain injury underwent surveillance digital subtraction angiography for a clipped pseudoaneurysm. Periprocedurally, the patient developed left gaze deviation, right hemiplegia, seizures, and magnetic resonance imaging findings consistent with posterior reversible encephalopathy syndrome. The diagnosis relied on distinct radiographic features, normal laboratory results, electroencephalography consistent with encephalopathy, no evidence of infection, a history of traumatic brain injury, and spontaneous clinical improvement. Posterior reversible encephalopathy syndrome can be triggered by cerebral blood flow changes or cytotoxic endothelial damage, particularly in individuals with compromised blood‐brain barrier integrity. Awareness of risk factors, pathophysiology, and clinical and radiographic patterns is crucial for accurate diagnosis. |
| format | Article |
| id | doaj-art-4a65b31dc3a5440b9547772b60a55e02 |
| institution | Kabale University |
| issn | 2694-5746 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Stroke: Vascular and Interventional Neurology |
| spelling | doaj-art-4a65b31dc3a5440b9547772b60a55e022025-08-20T03:52:15ZengWileyStroke: Vascular and Interventional Neurology2694-57462025-05-015310.1161/SVIN.124.001362Pressurized Contrast‐Related Posterior Reversible Encephalopathy Syndrome After Cerebral Digital Subtraction AngiographyLea Scherschinski0Tyler D. Schriber1Stefan W. Koester2Adam T. Eberle3Joshua S. Catapano4Ethan A. Winkler5Felipe C. Albuquerque6Michael T. Lawton7Andrew F. Ducruet8Ruchira M. Jha9Ashutosh P. Jadhav10Department of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZDepartment of Neurosurgery, Barrow Neurological Institute St. Joseph's Hospital and Medical Center Phoenix AZPosterior reversible encephalopathy syndrome is a multifactorial neurological disorder characterized by clinical and neuroimaging findings. The “vasogenic theory” suggests that, in this condition, disrupted cerebrovascular autoregulation leads to blood‐brain barrier failure and vasogenic edema. Posterior reversible encephalopathy syndrome is commonly associated with hypertension, chemotherapy, and transplantation, but neurosurgical patients, including those undergoing digital subtraction angiography, are also at elevated risk. A patient with a history of traumatic brain injury underwent surveillance digital subtraction angiography for a clipped pseudoaneurysm. Periprocedurally, the patient developed left gaze deviation, right hemiplegia, seizures, and magnetic resonance imaging findings consistent with posterior reversible encephalopathy syndrome. The diagnosis relied on distinct radiographic features, normal laboratory results, electroencephalography consistent with encephalopathy, no evidence of infection, a history of traumatic brain injury, and spontaneous clinical improvement. Posterior reversible encephalopathy syndrome can be triggered by cerebral blood flow changes or cytotoxic endothelial damage, particularly in individuals with compromised blood‐brain barrier integrity. Awareness of risk factors, pathophysiology, and clinical and radiographic patterns is crucial for accurate diagnosis.https://www.ahajournals.org/doi/10.1161/SVIN.124.001362aneurysmangiographyblood‐brain barrierblood pressurereversible leukoencephalopathytrauma |
| spellingShingle | Lea Scherschinski Tyler D. Schriber Stefan W. Koester Adam T. Eberle Joshua S. Catapano Ethan A. Winkler Felipe C. Albuquerque Michael T. Lawton Andrew F. Ducruet Ruchira M. Jha Ashutosh P. Jadhav Pressurized Contrast‐Related Posterior Reversible Encephalopathy Syndrome After Cerebral Digital Subtraction Angiography Stroke: Vascular and Interventional Neurology aneurysm angiography blood‐brain barrier blood pressure reversible leukoencephalopathy trauma |
| title | Pressurized Contrast‐Related Posterior Reversible Encephalopathy Syndrome After Cerebral Digital Subtraction Angiography |
| title_full | Pressurized Contrast‐Related Posterior Reversible Encephalopathy Syndrome After Cerebral Digital Subtraction Angiography |
| title_fullStr | Pressurized Contrast‐Related Posterior Reversible Encephalopathy Syndrome After Cerebral Digital Subtraction Angiography |
| title_full_unstemmed | Pressurized Contrast‐Related Posterior Reversible Encephalopathy Syndrome After Cerebral Digital Subtraction Angiography |
| title_short | Pressurized Contrast‐Related Posterior Reversible Encephalopathy Syndrome After Cerebral Digital Subtraction Angiography |
| title_sort | pressurized contrast related posterior reversible encephalopathy syndrome after cerebral digital subtraction angiography |
| topic | aneurysm angiography blood‐brain barrier blood pressure reversible leukoencephalopathy trauma |
| url | https://www.ahajournals.org/doi/10.1161/SVIN.124.001362 |
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