Advanced Imaging Techniques in Diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES)

Sheikh‐Bahaei, Nasim; Acharya, Jay; Rajamohan, Anandh G.; Kim, Paul E.

doi:10.3389/fneur.2020.00165

Cited by 20 publications

(14 citation statements)

References 41 publications

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“…These remain dominated by an acute cerebral stroke which, however, is systematized in a vascular territory, cerebral venous thrombosis whose involvement is diffuse, asymmetrical with possible hemorrhagic complication. The others are more diffuse, such asymmetrical post-infectious or vaccinal ADEM-type, autoimmune disorders with variable ADC and often nodular or circular enhancement, as well as pontine encephalopathies secondary to metabolic disorders [6] .…”

Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome (PRES): Should more attention be paid to the atypical forms?

Andour¹,

Cheraqui²,

Lahfidi³

et al. 2023

Radiology Case Reports

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Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome (PRES): Should more attention be paid to the atypical forms?

Andour¹,

Cheraqui²,

Lahfidi³

et al. 2023

Radiology Case Reports

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“…Hyperperfusion and hypoperfusion imaging patterns in PRES have been described in both CT perfusion and DSC MR perfusion, and multiple competing hypotheses exist to explain the variability seen in such advanced imaging techniques ( 4 ). The most often described explanation for hyperperfusion in PRES is felt to result from breakdown of cerebral autoregulation, often in the setting of severe hypertension, resulting in excessive blood flow, elevated capillary hydrostatic pressure, and subsequent vasogenic edema ( 3 ).…”

Section: Discussionmentioning

confidence: 99%

Added Value of Arterial Spin Labeling in Detecting Posterior Reversible Encephalopathy Syndrome as a Stroke Mimic on Baseline Neuroimaging: A Single Center Experience

et al. 2022

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Differentiating stroke from stroke mimics is a diagnostic challenge in every day practice. Posterior Reversible Encephalopathy Syndrome (PRES) is an important stroke mimic with nonspecific symptomatology, making prompt and accurate diagnosis challenging. Baseline neuroimaging plays a pivotal role in detection and differentiation of stroke from many common mimics and is thus critical in guiding appropriate management. In particular, MR perfusion (MRP) imaging modalities provide added value through detection and quantification of multiple physiological parameters. Arterial Spin Labeling (ASL) is a non-contrast, noninvasive MRP technique increasingly used in clinical practice; however, there is limited description of ASL in PRES in the existing literature. In this single center retrospective pilot study, we investigate the added value of ASL in detecting PRES in the largest series to date. We hope this study can serve as the basis for larger scale investigations exploring the utility of ASL in detecting stroke mimics such as PRES for accurate and efficient management of such patients.

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“…Brain imaging, particularly MRI, is the optimal radiological imaging to support the diagnosis of PRES and eliminate other differential diagnosis [ 13 , 14 , 15 , 16 , 17 ]. The vasogenic edema in PRES is characterized by bilateral hyper-intensity on FLAIR images in the parietal and occipital subcortical white matter [ 18 ] but low or iso-intense signals on T1-weighted MRI images, usually without ADC restriction.…”

Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome Following Chemotherapy and Immune Checkpoint Inhibitor Combination in a Patient with Small-Cell Lung Cancer

et al. 2022

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Posterior reversible encephalopathy syndrome (PRES) is a rare neurological complication that occurs following a sudden blood pressure increase. We report the case of a 64-year-old patient presenting PRES several hours after the administration of a combination of chemotherapy and a checkpoint inhibitor (carboplatin-etoposide-atezolizumab) for small-cell lung cancer. He presented consciousness disorders associated with partial epileptic seizure secondarily generalized. His arterial blood pressure was elevated and brain imaging showed multiple bilateral subcortical parietal, temporal, occipital and cerebellar T2 high signals, predominantly in the posterior region. There were no abnormal T1 signals nor bleeding but a left apparent diffusion coefficient restriction was noted. On arterial spin labelling perfusion sequences, there was an increased perfusion within the left temporo-parieto-occipital, left thalamic and right cerebellar regions. Finally, the neurological symptoms completely regressed after several days of optimal antihypertensive and antiepileptic treatment. The clinical context and radiological features, as well as the progressive resolution of the neurological symptoms, were all in favor of PRES. PRES can occur after the administration of chemotherapy and/or immunotherapy. Prompt diagnosis is crucial through a spectrum of suspicious clinical and radiological characteristics that must be rapidly recognized to quickly anticipate the optimal therapeutic strategy and avoid unnecessary complications.

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Advanced Imaging Techniques in Diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES)

Cited by 20 publications

References 41 publications

Posterior reversible encephalopathy syndrome (PRES): Should more attention be paid to the atypical forms?

Posterior reversible encephalopathy syndrome (PRES): Should more attention be paid to the atypical forms?

Added Value of Arterial Spin Labeling in Detecting Posterior Reversible Encephalopathy Syndrome as a Stroke Mimic on Baseline Neuroimaging: A Single Center Experience

Posterior Reversible Encephalopathy Syndrome Following Chemotherapy and Immune Checkpoint Inhibitor Combination in a Patient with Small-Cell Lung Cancer

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