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Posterior Reversible Encephalopathy Syndrome (PRES)

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Clinical Neuroradiology

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Abstract

Posterior reversible encephalopathy syndrome (PRES) encompasses a spectrum of imaging manifestations associated with acute encephalopathy and definite predisposing factors (hypertension, pregnancy, pathological conditions, and drugs). Although PRES was named after the first radiology reports with classic imaging presentations, not all cases of PRES are posterior or reversible. It is now clear that PRES shares imaging and pathogenic similarities with other conditions (e.g., reversible cerebral vasoconstriction syndrome, RCVS), that may represent a disease continuum rather than separate entities. Consistent medical history and clinical neuroradiology findings (vasogenic edema in typical locations) are crucial elements for diagnosis. Overall, PRES is a relatively benign condition that generally resolves after the treatment of the underpinning factors.

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Abbreviations

ADC:

Apparent Diffusion Coefficient

ARIA:

Amyloid-Related Imaging Abnormalities

ASL:

Arterial Spin Labeling

CAAri:

Cerebral Amyloid Angiopathy-related inflammation

CT:

Computed Tomography

DSC:

Dynamic Susceptibility Contrast

DWI:

Diffusion-Weighted Imaging

FFE T2*:

Fast Field Echo T2*

FLAIR:

Fluid-Attenuated Inversion Recovery

Gad:

Gadolinium

HMPAO:

Hexa-Methyl-Propylene-Amine Oxime

HUS:

Hemolytic Uremic Syndrome

IFN-alpha:

Interferon-alpha

IVIg:

Intravenous Immunoglobulins

MRA:

Magnetic Resonance Angiography

MRI:

Magnetic Resonance Imaging

MTT:

Mean Transit Time

NECT:

Non-enhanced CT

PAN:

Polyarteritis Nodosa

PCNSV:

Primary Central Nervous System Vasculitis

PRES:

Posterior Reversible Encephalopathy Syndrome

PRES-SCI:

Spinal Cord Involvement in PRES

rCBF:

Regional Cerebral Blood Flow

rCBV:

Regional Cerebral Blood Volume

RCVS:

Reversible Cerebral Vasoconstriction Syndrome

SPECT:

Single-Photon Emission Computed Tomography

SWI:

Susceptibility-Weighted Imaging

Tc99m:

Technetium-99

TOF:

Time of Flight

TTP:

Thrombotic Thrombocytopenic Purpura

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Authors and Affiliations

  1. Functional Neuroradiology Unit, Neuroradiology Department, Division of Neuroscience, IRCCS Ospedale San Raffaele, Milan, Italy

    Claudia Godi & Andrea Falini

Authors
  1. Claudia Godi
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  2. Andrea Falini
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Corresponding author

Correspondence to Claudia Godi .

Editor information

Editors and Affiliations

  1. Radiology and Nuclear Medicine, VU University Medical Center, Amsterdam, The Netherlands

    Frederik Barkhof

  2. National Hosp.f Neurology & Neurosurgery, UCL National Hosp.f Neurology & Neurosurgery, London, UK

    Rolf Jager

  3. Division of Neuroradiology, University Hospital Vienna Division of Neuroradiology, Wien, Austria

    Majda Thurnher

  4. Department of Neuroradiology, Hospital Vall d’Hebrón Department of Neuroradiology, Barcelona, Spain

    Alex Rovira Cañellas

Section Editor information

  1. Ospedale San Raffaele, Milan, Italy

    Andrea Falini

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Godi, C., Falini, A. (2018). Posterior Reversible Encephalopathy Syndrome (PRES). In: Barkhof, F., Jager, R., Thurnher, M., Rovira Cañellas, A. (eds) Clinical Neuroradiology. Springer, Cham. https://doi.org/10.1007/978-3-319-61423-6_83-1

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  • DOI: https://doi.org/10.1007/978-3-319-61423-6_83-1

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61423-6

  • Online ISBN: 978-3-319-61423-6

  • eBook Packages: Springer Reference MedicineReference Module Medicine

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