Study of Clinicoradiological Profile in Posterior Reversible Encephalopathy Syndrome: An Experience from North India

Abstract

A bstract Background Posterior reversible encephalopathy syndrome (PRES) is a reversible condition. The Main pathological feature is vasogenic cerebral edema with predominant involvement of posterior part of the cerebrum. Clinical symptoms range from headache, seizure, and vision loss. We evaluated the clinicoradiological features of patients with PRES and their clinical outcome. Materials and methods A retrospective study with 30 cases from January 2014 to May 2017. Results Of thirty patients, 18 were females and twelve patients were male. The Mean age of the patients was 38.6 years. The most common presentation was seizure (66.6%) followed by altered mental status (53.3%) and headache (40%). The Main comorbid illnesses in our study were renal disease (36.7%), hypertension (23.3%), eclampsia, and postpartum sepsis (26.7%). The Most common site was the occipito-parietal region in the magnetic resonance imaging brain (66%). Atypical presentation involved the temporal lobe (16%), basal ganglia (6%), and microhemorrhage (6%). The Outcome was good with 20% mortalities. Conclusion PRES is a reversible condition and has a good outcome in most patients. In our study, seizure was the most common presentation and renal disease is the most common comorbid illness. How to cite this article Goyal G, Jeswani J. Study of Clinicoradiological Profile in Posterior Reversible Encephalopathy Syndrome: An Experience from North India. Indian J Crit Care Med 2022;26(4):501–505.

Tacrolimus-induced posterior reversible encephalopathy syndrome following liver transplantation

“…Tacrolimus related PRES can present with a wide range of clinical symptoms, including tremors, headaches, seizures, gait instability and incoordination, altered mental status, visual disturbances, nausea and vomiting. The most common presentation is usually seizures and altered mental status[ 27 ]. Due to its nonspecific symptoms, PRES should always be considered in the appropriate patient subset as early recognition and timely intervention are crucial for reversing PRES and preventing long-term clinical sequelae.…”

Status Epilepticus as a Presenting Feature in Posterior Reversible Encephalopathy Syndrome: Tertiary Care Center Experience

“…It includes varying neurological symptoms, such as encephalopathy, seizures, headache, and vision disturbances with classical imaging findings of reversible subcortical vasogenic edema without the infraction. 1 , 2 Preeclampsia or eclampsia, hypertensive emergencies, renal disease, sepsis, exposure to immunosuppressive agents, and rarely autoimmune disorder are the precipitating factors. 2 – 6 The most common radiologic involvement in PRES is typically the “posterior” parieto-occipital white matter but the atypical areas, such as the cortex, basal ganglia, frontal lobes, and the brain stem can also be involved.…”

“… 1 , 2 Preeclampsia or eclampsia, hypertensive emergencies, renal disease, sepsis, exposure to immunosuppressive agents, and rarely autoimmune disorder are the precipitating factors. 2 – 6 The most common radiologic involvement in PRES is typically the “posterior” parieto-occipital white matter but the atypical areas, such as the cortex, basal ganglia, frontal lobes, and the brain stem can also be involved. 1 , 7 PRES due to hypertension emergencies is due to failure of cerebrovascular autoregulation, resulting in vasogenic edema.…”