Posterior reversible encephalopathy syndrome caused by hypertensive encephalopathy and acute uremia
The posterior reversible encephalopathy syndrome (PRES) is a recently proposed cliniconeuroradiological entity. The most common causes of PRES are hypertensive encephalopathy, eclampsia, cyclosporin A neurotoxicity, and the uremic encephalopathy. On magnetic resonance imaging (MRI) studies, edema has been reported in a relatively symmetrical pattern, typically in the subcortical white matter and occasionally in the cortex of the posterior circulation area of the cerebrum.
Methods and Results
A 19-year-old woman undergoing chronic hemodialysis was admitted with encephalopathy. High signal intensity was seen bilaterally in the subcortical and deep white matter areas of the temporal, frontal, parietal, and occipital lobes on cranial MRI.
Particular attention needs to be given to PRES because initiation of appropriate intervention can reverse the encephalopathic condition in most cases. Cerebral lesions may be more prominent in the anterior circulation area in some patients.
Key WordsPosterior reversible encephalopathy syndrome uremia hypertensive encephalopathy FLAIR MRI
Unable to display preview. Download preview PDF.
- 9.Lamy C, Mas JL. Hypertensive encephalopathy. In: Mohr JP, Choi D, Grota JC, Weir B, Wolf PA, eds. Stroke: pathophysiology, diagnosis and management, 4th ed. Philadelphia: Churchill Livingstone 2004:641–647.Google Scholar