La leucoencéphalopathie postérieure réversible

Amoli, A. Mohebbi; Mégarbane, Bruno; Chabriat, Hugues

doi:10.1016/j.reaurg.2007.09.021

Cited by 12 publications

(4 citation statements)

References 41 publications

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“…The pathophysiology of PRES is not yet fully understood, however, it is thought to be due to a disturbance of the autoregulation of cerebral vascular pressures and/or lesions of the endothelium leading to the formation of vasogenic cerebral edema. 2 Therefore, this entity occurs only in certain specific conditions (Table 1), and more frequently in cases of arterial hypertension with a diastolic blood pressure greater than 120 mmHg. In this condition, PRES represents one of the complications of hypertensive encephalopathy.…”

Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome: A Complication of Acute Renal Failure in a Child

Traore,

Diallo,

Yassin

et al. 2023

Global Pediatric Health

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Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological entity occurring during several conditions and more frequently in those associated with severe hypertension. The diagnostic approach is possible by considering the clinical context and MRI data, where white matter abnormalities are observed predominantly in the parietal and occipital territories secondary to the formation of a vasogenic edema. The evolution is characterized by a reversibility of the lesions in case of early diagnosis and management. The authors report a case of reversible posterior encephalopathy in a 12-year-old child who presented with a status epilepticus, revealing an acute renal failure.

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Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome: A Complication of Acute Renal Failure in a Child

Traore,

Diallo,

Yassin

et al. 2023

Global Pediatric Health

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“…Only early diagnosis makes it possible to start a suitable treatment before the installation of irreversible lesions [7] . The PRES syndromes secondary to calcineurin inhibitors may have occurred even with a residual level in the therapeutic range [20] .…”

Section: Discussionmentioning

confidence: 99%

Tacrolimus Associated Posterior Reversible Encephalopathy Syndrome (PRES): About a case

Hamidi¹,

Bedou²,

Lahlali³

et al. 2018

J. Med. Res.

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The Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological syndrome, it may occur due to a number of causes, including the use of immunosuppressive treatments. It is a rare entity. We report here the occurrence of a PRES syndrome in a patient treated with tacrolimus after liver transplantation, revealed by ocular manifestations associated with intermittent headaches of moderate intensity and tremor in the hands later complicated by a condition epilepticus. The brain scan showed an occipital hematoma in resorption and a lumbar puncture with normal pressure measurement. The brain MRI had objectified on the FLAIR sequence an evocative aspect of reversible posterior encephalopathy in the posterior occipital and parietal territory. Antiepileptic treatment was introduced and tacrolimus was replaced by ciclosporin, given the strong presumption of its involvement in the occurrence of this PRES, with good evolution. The prognosis of PRES is generally favorable under treatment, with a risk of serious sequelae in case of delayed diagnosis justifying that this syndrome must be evoked in front of neurological manifestations in a patient on tacrolimus.

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“…The first clinical signs of PRES are unusual headache and altered mental status (4,41,42). Nausea, vomiting, and seizures are described in 75% of patients.…”

Section: Clinico-radiological Criteria: Criteria and Sequelae In Our mentioning

confidence: 99%

“…The most common finding is edema without infarction of the sub-cortical white matter of the temporo-parieto-occipital lobes; this sign is usually bilateral and symmetric. Calcarine fissure and the paramedian area of occipital lobes are often spared (4,41,49). Gray matter is involved in only 30% of patients (50,51).…”

Section: Radiological Findingsmentioning

confidence: 99%

Delayed Posterior Reversible Leukoencephalopathy Syndrome Triggered by FLOT Chemotherapy

2020

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Posterior reversible encephalopathy syndrome (PRES) is a potentially severe disorder of the autoregulation of cerebral perfusion. The major clinical manifestations are headache, seizures, altered mental status, and visual loss. The typical radiological finding is vasogenic edema predominating in the white matter of occipital and parietal lobes. PRES is increasingly recognized as a clinico-radiological entity owing to improvements and fast availability of brain imaging, especially magnetic resonance imaging (MRI). We present the exceptional case of a 67-year-old female patient with a gastric adenocarcinoma at stage IIB (T3N0M0) treated by FLOT chemotherapy (5-fluorouracil, oxaliplatin, docetaxel, and folinic acid). Two months after the unique administration of FLOT regimen, she developed sudden posterior headache and visual loss. Blood pressure values were normal. Cerebral tomography showed ischemic-like occipital bilateral lesions, and angiographic sequences revealed breakdown of the blood-brain barrier (BBB). MRI revealed bilateral parieto-occipital T1 hypointensity and T2 hyperintensity, which demonstrated vasogenic edema. The rest of the parts of the lesions were T1 hyperintensity, T2 hyperintensity, and diffusion-weighted imaging (DWI) hyperintensity, which indicate cortical laminar necrosis. After injection of gadolinium, a linear enhancement of the cortex was observed. She was treated with oral nimodipine. Follow-up was characterized by permanent visual sequelae and tetraparesis. PRES represents an urgent neurological condition. Our observation highlights that PRES should be considered in patients under chemotherapy, even when their blood pressure remains within normal range. This is the first report of PRES triggered by FLOT chemotherapy and with a silent window of 2 months between chemotherapy and PRES, widening further the spectrum of chemotherapy-induced PRES. Our case highlights the potential role of FLOT regimen in the pathogenesis of PRES and the need for a novel approach in terms of prevention of this potentially fatal complication when patients receive chemotherapy.

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La leucoencéphalopathie postérieure réversible

Cited by 12 publications

References 41 publications

Posterior Reversible Encephalopathy Syndrome: A Complication of Acute Renal Failure in a Child

Posterior Reversible Encephalopathy Syndrome: A Complication of Acute Renal Failure in a Child

Tacrolimus Associated Posterior Reversible Encephalopathy Syndrome (PRES): About a case

Delayed Posterior Reversible Leukoencephalopathy Syndrome Triggered by FLOT Chemotherapy

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