Posterior reversible encephalopathy syndrome: a case report and review of the literature

Posterior reversible encephalopathy syndrome (PRES) is a rare condition that is diagnosed based on clinical and radiological findings. Usually this condition manifests with acute neurological symptoms, such as headache, impaired consciousness, seizures and/or vision disturbances with fluctuations i...

Full description

Saved in:
Bibliographic Details
Main Authors: G. V. Urbonaitė, E. Audronytė, J. Valaikienė
Format: Article
Language:English
Published: Vilnius University Press 2020-09-01
Series:Neurologijos seminarai
Subjects:
Online Access:https://www.journals.vu.lt/neurologijos_seminarai/article/view/27734
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1832593083207778304
author G. V. Urbonaitė
E. Audronytė
J. Valaikienė
author_facet G. V. Urbonaitė
E. Audronytė
J. Valaikienė
author_sort G. V. Urbonaitė
collection DOAJ
description Posterior reversible encephalopathy syndrome (PRES) is a rare condition that is diagnosed based on clinical and radiological findings. Usually this condition manifests with acute neurological symptoms, such as headache, impaired consciousness, seizures and/or vision disturbances with fluctuations in arterial blood pressure, and neuroimaging abnormalities of bilateral subcortical vasogenic edema, usually seen in occipital lobes. The pathophysiology of this syndrome is still debated, however, it is thought that PRES develops due to the endothelial dysfunction. PRES should be suspected when acute neurological symptoms develop in patients with renal insufficiency, arterial hypertension or fluctuations in blood pressure, eclampsia, sepsis, and autoimmune diseases who are taking immunosupressive or citotoxic medications. The main treatment consists of the removal of the precipitating factors (correction of arterial hypertension, cessation of immunosupressive treatment or dose reduction). The prognosis is usually good, with a regresion in clinical and radiological symptoms and signs in several days or weeks. Very rarely, PRES can have complications like intracerebral hemmorhage, severe brain edema, and fatal outcome or persisting disability. In this article, we present a rare clinical case when PRES was diagnosed accidentally during a follow-up head magnetic resonance imaging of meningioma. The patient, who had suffered from chronic headaches for several years, had arterial hypertension with fluctuations in blood pressure. Typical radiological signs of PRES remained visible after 1, 3 and 6 months and completely regressed after a year.
format Article
id doaj-art-b85c92d489d94deb80b28a75576a17b3
institution Kabale University
issn 1392-3064
2424-5917
language English
publishDate 2020-09-01
publisher Vilnius University Press
record_format Article
series Neurologijos seminarai
spelling doaj-art-b85c92d489d94deb80b28a75576a17b32025-01-20T18:22:38ZengVilnius University PressNeurologijos seminarai1392-30642424-59172020-09-01243(85)10.29014/ns.2020.34Posterior reversible encephalopathy syndrome: a case report and review of the literatureG. V. Urbonaitė 0E. Audronytė 1J. Valaikienė 2Vilnius University, LithuaniaVilnius University, LithuaniaVilnius University, Lithuania Posterior reversible encephalopathy syndrome (PRES) is a rare condition that is diagnosed based on clinical and radiological findings. Usually this condition manifests with acute neurological symptoms, such as headache, impaired consciousness, seizures and/or vision disturbances with fluctuations in arterial blood pressure, and neuroimaging abnormalities of bilateral subcortical vasogenic edema, usually seen in occipital lobes. The pathophysiology of this syndrome is still debated, however, it is thought that PRES develops due to the endothelial dysfunction. PRES should be suspected when acute neurological symptoms develop in patients with renal insufficiency, arterial hypertension or fluctuations in blood pressure, eclampsia, sepsis, and autoimmune diseases who are taking immunosupressive or citotoxic medications. The main treatment consists of the removal of the precipitating factors (correction of arterial hypertension, cessation of immunosupressive treatment or dose reduction). The prognosis is usually good, with a regresion in clinical and radiological symptoms and signs in several days or weeks. Very rarely, PRES can have complications like intracerebral hemmorhage, severe brain edema, and fatal outcome or persisting disability. In this article, we present a rare clinical case when PRES was diagnosed accidentally during a follow-up head magnetic resonance imaging of meningioma. The patient, who had suffered from chronic headaches for several years, had arterial hypertension with fluctuations in blood pressure. Typical radiological signs of PRES remained visible after 1, 3 and 6 months and completely regressed after a year. https://www.journals.vu.lt/neurologijos_seminarai/article/view/27734arterial hypertensionposterior reversible encephalopathy syndromePREShypertensive encephalopathymeningiomaheadaches
spellingShingle G. V. Urbonaitė
E. Audronytė
J. Valaikienė
Posterior reversible encephalopathy syndrome: a case report and review of the literature
Neurologijos seminarai
arterial hypertension
posterior reversible encephalopathy syndrome
PRES
hypertensive encephalopathy
meningioma
headaches
title Posterior reversible encephalopathy syndrome: a case report and review of the literature
title_full Posterior reversible encephalopathy syndrome: a case report and review of the literature
title_fullStr Posterior reversible encephalopathy syndrome: a case report and review of the literature
title_full_unstemmed Posterior reversible encephalopathy syndrome: a case report and review of the literature
title_short Posterior reversible encephalopathy syndrome: a case report and review of the literature
title_sort posterior reversible encephalopathy syndrome a case report and review of the literature
topic arterial hypertension
posterior reversible encephalopathy syndrome
PRES
hypertensive encephalopathy
meningioma
headaches
url https://www.journals.vu.lt/neurologijos_seminarai/article/view/27734
work_keys_str_mv AT gvurbonaite posteriorreversibleencephalopathysyndromeacasereportandreviewoftheliterature
AT eaudronyte posteriorreversibleencephalopathysyndromeacasereportandreviewoftheliterature
AT jvalaikiene posteriorreversibleencephalopathysyndromeacasereportandreviewoftheliterature