Spontaneous bilateral carotid artery dissection and posterior reversible encephalopathy syndrome

SUMMARY:Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state coupled with a unique CT or MR imaging appearance. Recognized in the setting of a number of complex conditions (preeclampsia/eclampsia, allogeneic bone marrow transplantation, organ transplantation, autoimmune disease and high dose chemotherapy) the imaging, clinical and laboratory features of this toxic state are becoming better elucidated. This review summarizes the basic and advanced imaging features of PRES, along with pertinent features of the clinical and laboratory presentation and available histopathology. Many common imaging/clinical/laboratory observations are present among these patients, despite the perception of widely different associated clinical conditions.

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“…17 51, 109 These CA/MRA features reflect previously described vessel histologic observations. MR venography has tended to be normal in PRES.…”

Section: Advanced Imaging In Pressupporting

confidence: 78%

Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features

Bartynski¹

2008

AJNR Am J Neuroradiol

957

890

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“…In our patient, we postulate that the patient's spontaneous carotid artery dissection led to baroreceptor reflex failure and resultant hypertension, although we cannot exclude a contributing role from pseudoephedrine. Baroreceptor reflex failure can induce hypertensive encephalopathy after carotid endarterectomy [5] and a similar mechanism can occur after extracranial carotid dissections [6]. Centrally acting antihypertensives, such as clonidine, can be helpful in reducing sympathoneural outflow.…”

Section: Posterior Reversible Encephalopathy Syndrome á Presmentioning

confidence: 99%

A PRESsing Dissection

et al. 2010

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“…Other proposed associations with PRES are frequently reported, and include tumor lysis syndrome [25], methylprednisolone [26], scleroderma [27], bilateral carotid artery 480 Neuro-ophthalmology dissection [28], dexamethasone [29], hypercalcemia [30], nitroglycerin [31], LSD [32 ], traditional Chinese medicines [33] and implantation of a left ventricular assist device [34]. Causation is ultimately related to pathophysiology, and some of these associations may be coincidental.…”

Section: Predisposing Factorsmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome

Pula

Eggenberger

2008

Current Opinion in Ophthalmology

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Acute hypertension, eclampsia, immunosuppressive medication, infection or autoimmune diseases can all result in the clinical syndrome of vasogenic edema in the central nervous system leading to headache, seizure, confusion and frequent visual loss. The biologic basis for the syndrome is likely an insult to cerebral vascular autoregulation. MRI is essential in diagnosing a cerebral cause for visual loss. The ophthalmologist may have the initial opportunity to diagnose the syndrome. Treatment may reverse clinical deficits, and is based on eliminating the etiologic causation.

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Spontaneous bilateral carotid artery dissection and posterior reversible encephalopathy syndrome

Cited by 10 publications

References 7 publications

Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features

Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features

A PRESsing Dissection

Posterior reversible encephalopathy syndrome

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