Cortical blindness secondary to posterior reversible encephalopathy syndrome, recovered by successful blood pressure management

Abalo-Lojo, José Manuel; Baleato-González, Sandra; González, Francisco

doi:10.5935/0004-2749.20170079

Cited by 4 publications

(3 citation statements)

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“…La sospecha diagnóstica se corrobora mediante métodos no invasivos, como con la tomografía computada simple o contrastada, en la que se evidenciará edema cerebral bilateral predominante en los lóbulos parietales y occipitales 6,7 . Dichas lesiones pueden orientar o bien servir como método para descartar otras patologías que pudieran ocasionar un cuadro clínico similar, como accidentes cerebrovasculares, síndrome de vasoconstricción cerebral, disección de la arteria cerebral, migraña, neuroinfecciones, enfermedades autoinmunitarias o metabólicas, y trastornos desmielinizantes 8,9 . En la mayoría de los casos, como en nuestra paciente, es el método de imagen inicial por ser útil para la exclusión de diagnósticos paralelos y establecer la pauta para la confirmación mediante otras técnicas más sensibles.…”

Section: Discussionunclassified

Encefalopatía posterior reversible atípica secundaria a eclampsia. Presentación de un caso

Martín-Matamoros¹,

Soto-Salamanca²,

Cerón-Morales³

et al. 2020

CIRU

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La encefalopatía posterior reversible se relaciona con enfermedades hipertensivas del embarazo, con clínica inespecífica. El diagnóstico se realiza mediante resonancia magnética y electroencefalograma, y el tratamiento oportuno evita complicaciones. Caso clínico: Primigesta de 15 años con embarazo pretérmino, hipertensión arterial y convulsiones tónico-clónicas, que desarrolló encefalopatía posterior atípica con múltiples lesiones cerebrales. Se administraron antihipertensivos, sin mejoría de los síntomas neurológicos. El manejo de esta patología depende de la situación desencadenante, no existe evidencia suficiente del soporte con medidas antiedema preventivas en pacientes con factores de riesgo. El retraso en el tratamiento oportuno y la presentación atípica favorecen la progresión de las secuelas neurológicas.

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Section: Discussionunclassified

Encefalopatía posterior reversible atípica secundaria a eclampsia. Presentación de un caso

Martín-Matamoros¹,

Soto-Salamanca²,

Cerón-Morales³

et al. 2020

CIRU

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show abstract

“…With timely and appropriate treatment, the clinical symptoms and imaging changes of PRES can be rapidly improved, even completely recovered (7). Among the raft of causative factors of PRES, hypertension is one of the most common (8); hypertension is also the most common risk factor for acute cerebral infarction (9). However, the pathophysiological mechanisms between PRES and acute cerebral infarction are not the same.…”

Section: Introductionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome coexists with acute cerebral infarction: challenges of blood pressure management

Liu

Zhang

2020

Quant Imaging Med Surg

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Hypertension is the most common cause of posterior reversible encephalopathy syndrome (PRES) and acute cerebral infarction. Due to the lack of randomized controlled clinical trials (RCTs), early antihypertensive methods are diverse, even contradictory. So far, there is no consensus on the method of blood pressure (BP) management when the 2 diseases coexist. Generally, antihypertensive therapy should be initiated quickly in the acute phase of PRES, as most patients have elevated BP. However, various factors must be considered before the administration of early antihypertensive therapy in acute cerebral infarction.The coexistence of PRES and acute cerebral infarction is uncommon clinically, and more complicated subsequent BP management. This article reports a case of PRES coexisting with acute lacunar cerebral infarction, which was caused by hypertension. We have analyzed and summarized the antihypertensive principles in PRES and different phases of acute cerebral ischemic injury. We assert that when PRES and acute cerebral infarction coexist, the antihypertensive treatment should be individualized, and careful consideration should be given to the various influencing factors.

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“…Cerebral angiography, though being associated with multiple known complications, is still considered as the gold standard for diagnosing cerebrovascular diseases 1,2. Cortical visual impairment is one of the uncommon complications following cerebral angiography, myeloangiography intervention, and vascular interventional therapy at the coronary artery, aorta, brachial plexus, and brain 3–5. Transient cortical visual impairment occurs most frequently after cerebral angiography, with an incidence of 0.3–1.0% 4,6.…”

Section: Introductionmentioning

confidence: 99%

<p>The potential risk factors of cortical visual impairment following cerebral angiography: a retrospective study</p>

Yang¹,

Zhang²,

Li³

2019

TCRM

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BackgroundCortical visual impairment is an uncommon complication after cerebral angiography with an incidence of 0.3%-1.0%. Here we would like to investigate and discuss the potential risk factors of cortical visual impairment after cerebral angiography.MethodsBased on the presence of post-operative cortical visual impairment, 4,528 patients who received cerebral angiography were split into two groups. The relevant risk factors were compared and analyzed between the groups.ResultsIn the patient cohort, 11 cases exhibited post-operative cortical visual impairment (0.24%). In particular, seven patients presented with blurred vision and four presented with binocular blindness. Visual sensation of these patients recovered after the treatment. Our univariate analysis revealed that differences in age, weight, sex ratios, proportions of patients with hypertension, diabetes and hyperlipemia, and operation time were not statistically significant between the two groups (P>0.05). The multivariate analysis indicated that the dosage of contrast medium was the independent risk factor for post-operative cortical visual impairment.ConclusionClinically, cortical visual impairment following cerebral angiography typically presented as blurred vision or complete blindness. We have identified the dosage of contrast medium as the most critical independent risk factor based on our study. Preventive strategies need to be implemented to avoid post-operative cortical visual impairment in this regard.

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Cortical blindness secondary to posterior reversible encephalopathy syndrome, recovered by successful blood pressure management

Cited by 4 publications

References 0 publications

Encefalopatía posterior reversible atípica secundaria a eclampsia. Presentación de un caso

Encefalopatía posterior reversible atípica secundaria a eclampsia. Presentación de un caso

Posterior reversible encephalopathy syndrome coexists with acute cerebral infarction: challenges of blood pressure management

<p>The potential risk factors of cortical visual impairment following cerebral angiography: a retrospective study</p>

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