The diagnosis of posterior reversible encephalopathy syndrome

Grioni, Daniele; Rovelli, Attilio; Pavan, Fabio; Prunotto, Giulia

doi:10.1016/s1474-4422(15)00254-9

Cited by 6 publications

(6 citation statements)

References 3 publications

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“…The patient we reported here also suffered from hyper perfusion due to severe hypertension, which further confirmed the above theory. Generally, the visualized brain oedema could be recognized on brain MRI or CT, with bilateral and symmetrical posterior white matter lesions mainly involving parieto-occipital lobes [9,10]. Involvement of the cerebral cortex and basal ganglia are less common, which is observed in the case we reported here.…”

Section: Discussionmentioning

confidence: 47%

Posterior Reversible Encephalopathy Syndrome with Bad Imaging of Cerebral Venous Sinus: A Case Report

Zhou¹,

Huang²,

Jiang³

et al. 2016

Commun Disord Deaf Stud Hearing Aids

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Posterior Reversible Encephalopathy Syndrome (PRES) refers to a disorder of reversible subcortical vasogenic oedema in patients with acute neurological symptoms. Its clinical manifestations include seizures, visual disturbances, headache, confusion, impaired consciousness, ataxia, and other focal neurological signs. It is a complex and multidisciplinary disease with the pathophysiological changes still controversial. Therefore, clinical and neuro-imaging judgment seems so crucial. Here, we reported a case of PRES with bad imaging of cerebral venous sinus, which reminds us that the atypical imaging of RPES should be recognized to make early diagnosis and start immediate treatment.

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Section: Discussionmentioning

confidence: 47%

Posterior Reversible Encephalopathy Syndrome with Bad Imaging of Cerebral Venous Sinus: A Case Report

Zhou¹,

Huang²,

Jiang³

et al. 2016

Commun Disord Deaf Stud Hearing Aids

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“…PRES presents classically with altered mental status (50%-80%), headaches (50%), seizures (60%-75%), and visual disturbances (33%). 1,2 On MRI, one often sees vasogenic edema bilaterally in parieto-occipital and posterior frontal cortical and subcortical white matter. A subset of patients may present with focal infarcts (10%-25% of cases) or intracranial hemorrhage (10%-15% of cases).…”

Section: Discussionmentioning

confidence: 99%

Pearls & Oy-sters: The dangers of PRES

et al. 2019

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The presentation of posterior reversible encephalopathy syndrome (PRES) can be highly variable, with headaches and seizures being common. c PRES should be considered even if imaging findings are in an atypical location such as the brainstem or diencephalon. c PRES may present with life-threatening acute obstructive hydrocephalus, which requires prompt treatment. Oysters c Prognosis of PRES is usually good, especially if the cause can be identified and treated. c PRES can recur, or it can present with ischemic events or intracranial hemorrhage. c Immunosuppressant medications can be associated with PRES. Changing to a nonoffending agent is necessary for reversal of PRES.

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“…In a study conducted on adult oncology patients with PRES, the most common EEG finding on a standard recording was diffuse slowing (44). Grioni et al described video EEG recordings of ten patients with PRES with diffuse slowing and focal unilateral temporo-occipital activity (45). A cohort of critically ill adults with PRES on continuous EEG monitoring reported that 62% had non-convulsive seizures or periodic discharges with 74% localized to the posterior region (39).…”

Section: The Differences In Clinical Presentation May Suggest Differe...mentioning

confidence: 99%

Different Clinicoradiological Characteristics of Posterior Reversible Encephalopathy Syndrome in Pediatric Oncology and Post-Bone Marrow Transplantation Cases: A Retrospective Study

et al. 2022

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Posterior reversible encephalopathy syndrome (PRES) is receiving increasing recognition in pediatrics. However, comparisons between PRES in pediatric oncology and post-bone marrow transplantation (BMT) are lacking. Therefore, we aimed to describe the risk factors and clinical and radiological features of PRES and investigate the differences between PRES in pediatric oncology and post-BMT. The PRES data of 13 patients from our center were combined with those of 217 cases from the PubMed, Scopus, and Web of Science databases. The patients were divided into either an oncology or a post-BMT group. We included 230 patients in the analysis, 26.1% of whom belonged to the post-BMT group. Oncology patients developed PRES at a younger age (p = 0.010) and were more likely to develop encephalopathy (p = 0.004). Systemic hypertension (S-HTN) preceding PRES occurred in 43.5% (66/154) of patients. Post-BMT patients were more likely to have S-HTN (p = 0.003). Cyclosporine levels were detected in 37 patients; 40.5% had supra-therapeutic levels. The radiological findings were atypical in 74.3% of patients, and delayed repeated imaging increased the occurrence of resolution (p = 0.004). Sixteen (7%) patients developed PRES recurrence after a median of 8 weeks, with the between-group difference being non-significant. Oncology patients were more likely to develop chronic epilepsy, while BMT patients were more likely to develop rare neurologic abnormalities (p < 0.001). In conclusion, atypical clinical presentation and imaging findings should not hinder the diagnosis of PRES. S-HTN is a risk factor, particularly in post-BMT patients. Supra-therapeutic levels of cyclosporine and previous exposure to immunosuppression did not increase the risk of recurrence.

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The diagnosis of posterior reversible encephalopathy syndrome

Cited by 6 publications

References 3 publications

Posterior Reversible Encephalopathy Syndrome with Bad Imaging of Cerebral Venous Sinus: A Case Report

Posterior Reversible Encephalopathy Syndrome with Bad Imaging of Cerebral Venous Sinus: A Case Report

Pearls & Oy-sters: The dangers of PRES

Different Clinicoradiological Characteristics of Posterior Reversible Encephalopathy Syndrome in Pediatric Oncology and Post-Bone Marrow Transplantation Cases: A Retrospective Study

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