Neurocritical Care

, Volume 4, Issue 3, pp 245–247 | Cite as

Asymmetric reversible posterior leukoencephalopathy syndrome

  • Heidi M. Schambra
  • David M. Greer
Practical Pearl


Reversible posterior leukoencephalopathy syndrome (RPLS) is characterized radiographically by magnetic resonance imaging as white matter hyperintensities, which reflect cerebral edema. These changes are typically restricted to the parietal and occipital lobes, and are usually quite symmetric. We report a case of asymmetric RPLS involving only one frontal lobe in a patient with severe hypertension chronic internal carotid artery stenosis, and ipsilateral vasogenic edema.

Key Words

Reversible posterior leukoencephalopathy hyperperfusion syndrome carotid stenosis vasogenic edema cerebrovascular autoregulation 


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  1. 1.
    Chester EM, Agamanolis DP, Banker BQ, et al. Hypertensive encephalopathy: a clinicopathologic study of 20 cases. Neurology 1978;28:928–939.PubMedGoogle Scholar
  2. 2.
    Singhal AB. Postpartum angiopathy with reversible posterior leukoencephalopathy. Arch Neurol 2004;61:411–416.PubMedCrossRefGoogle Scholar
  3. 3.
    Stott VL, Hurrell MA, Anderson TJ. Reversible posterior leukoencephalopathy syndrome: a misnomer reviewed. Int Med J 2005;35:83–90.CrossRefGoogle Scholar
  4. 4.
    Schaefer PW, Buonanno FS, Gonzales RG, et al. Diffusion-weighted imaging discriminates between cytotoxic and vasogenic edema in a patient with eclampsia Stroke 1997;28:1082–1085.PubMedGoogle Scholar
  5. 5.
    Lamy C, Oppenheim C, Méder JF, et al. Neuromaging in posterior reversible encephalopathy syndrome. J Neuroimaging 2004;14:89–96.PubMedCrossRefGoogle Scholar
  6. 6.
    Ahn KJ, You WJ, Jeong SL. Atypical manifestations of reversible posterior leukoencephalopathy syndrome: findings on diffusion imaging and ADC mapping. Neuroradiology 2004;46:978–983.PubMedCrossRefGoogle Scholar
  7. 7.
    Karapanayiotides T, Meuli R, Devuyst G, et al. Postcarotid endarterectomy hyperperfusion or reperfusion syndrome. Stroke 36: 21–26.Google Scholar
  8. 8.
    Jorgensen LG, Schroeder TV. Defective cerebrovascular autoregulation after carotid endarterectomy Eur J Vasc Surg 1993;7:370–379.PubMedCrossRefGoogle Scholar

Copyright information

© Humana Press Inc 2006

Authors and Affiliations

  1. 1.Department of Neurology, ACC 835Massachusetts General HospitalBoston

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