scholarly journals Posterior Reversible Encephalopathy Syndrome in a Patient with Hemorrhagic Fever with Renal Syndrome

2020 ◽  
Vol 2020 ◽  
pp. 1-5
Author(s):  
Ermira Muco ◽  
Amela Hasa ◽  
Arben Rroji ◽  
Arta Kushi ◽  
Edmond Puca ◽  
...  
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Supportive Therapy ◽  
Hemorrhagic Fever ◽  
Elisa Test ◽  
Albumin Level ◽  
Hantavirus Infection ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Physical Findings

We presently report the case of hantavirus infection in a 45-year-old male who was hospitalized to our clinic of infectious diseases, with fever, myalgia, vomiting, nausea, headache, and abdominal pain. The physical findings included hepatomegaly, splenomegaly, rash, and conjunctival injection. Eight days before the start of complaints, the patient has cut trees in the mountain. An acute renal failure was observed with an oliguria and an increase of serum creatinine and blood urea nitrogen. Urinalysis shows albuminuria and hematuria. Elevations of amylase, lipase, and liver enzymes levels, low serum albumin level, and thrombocytopenia were observed. A positive ELISA test for hantavirus IgM/IgG antibodies confirmed hemorrhagic fever with renal syndrome. On the third day of hospitalization, the patient had seizures. The unenhanced head computed tomography (CT) performed after seizures showed subcortical bilateral hypodensities within frontal, parietal, and occipital regions corresponding to areas of increased signal intensity in magnetic resonance imaging (MRI) associated with cerebral edema in posterior reversible encephalopathy syndrome (PRES). The treatment consisted of supportive therapy. The patient underwent another head MRI with contrast enhancement after 2 months, which resulted normal.

scholarly journals Eclampsia-Induced Posterior Reversible Encephalopathy Syndrome in a Donor Oocyte Recipient

2021 ◽  
Author(s):  
Jesús Garcia Castro ◽  
Jorge Rodríguez-Pardo ◽  
Javier Díaz de Terán
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Illustrative Case ◽  
Posterior Reversible Encephalopathy ◽  
Donor Oocyte ◽  
Oocyte Fertilization ◽  
Emergency Cesarean ◽  
Hypertensive Disorders In Pregnancy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Objective: Posterior reversible encephalopathy syndrome (PRES) has been robustly associated with preeclampsia, hyperperfusion or endothelial dysfunction suggested as possible mechanisms. In this article, we report an illustrative case of this complication in a patient with risk factors for hypertensive disorders in pregnancy, including advanced maternal age and donor oocyte fertilization. Case report: We present a case of a 40-year-old pregnant, donor oocyte recipient with sudden decreased visual acuity accompanied by hypertension, proteinuria and tonic-clonic seizures. Magnetic resonance imaging (MRI) of the brain showed bilateral lesions in the parieto-occipital regions suggestive of vasogenic edema, leading us to suspect posterior reversible encephalopathy syndrome. The patient underwent an emergency cesarean section and labetalol and magnesium sulfate were administered intravenously. The neurological symptoms and radiological findings resolved following delivery and the patient’s blood pressure normalized, supporting the diagnosis of posterior reversible encephalopathy syndrome. Conclusion: Pregnancy by donor oocyte fertilization may entail a higher risk of eclampsia and associated posterior reversible encephalopathy syndrome.  

scholarly journals Posterior reversible encephalopathy syndrome mimicking cerebral metastasis: contraindication for biopsy

2014 ◽  
Vol 4 (1) ◽  
Author(s):  
Dukagjin Morina ◽  
Georgios Ntoulias ◽  
Homajoun Maslehaty ◽  
Martin Scholz ◽  
Athanasios K. Petridis
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Resonance Imaging ◽  
Open Biopsy ◽  
Posterior Reversible Encephalopathy ◽  
Typical Appearance ◽  
Magnetic Resonance Imaging Mri ◽  
Immunosupressive Therapy ◽  
Reversible Encephalopathy ◽  
Radiologic Features

The posterior reversible encephalopathy syndrome (PRES) is a well described entity of white matter pathology. PRES is triggered by numerous different factors such as acute elevated arterial hypertension, immunosupressive therapy, chemotherapy, etc. The case of a 67-year old woman is presented. The patient was treated for breast cancer 10 months ago and because of acute disorientation a magnetic resonance imaging (MRI) was performed. In the MRI biparieto-occipital hyperintense lesions were seen. Brain metastases were suspected. After chemothe - rapy and hypertonia and the typical appearance of the lesions in the MRI, PRES was also suspected. Before initializing the surgery for an open biopsy a follow-up MRI had been performed (2 weeks after initial MRI). In follow-up MRI the lesions disappeared completely proving the diagnosis of PRES. PRES can be misdiagnosed as a tumour and surgery could be mistakenly performed. It’s important to keep the differential diagnosis of PRES in mind when radiologic features of the syndrome are present.

scholarly journals Posterior Reversible Encephalopathy Syndrome and Azathioprine

2019 ◽  
Author(s):  
Sara Pinto Teixeira Vilas-Boas ◽  
Ana Corte-Real
Keyword(s):  
Magnetic Resonance Imaging ◽  
Status Epilepticus ◽  
White Matter ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Severe Hypertension ◽  
Neurological Manifestations ◽  
Resonance Imaging ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a rare syndrome that presents with neurological manifestations, often associated with arterial hypertension. Magnetic resonance imaging (MRI) shows bilateral white matter oedema in the posterior vascular territories. Immunosuppression, (pre) eclampsia and autoimmune diseases can be implicated. A 27-year-old woman, with mixed connective tissue disease under azathioprine, was admitted in the emergency room in status epilepticus and with severe hypertension. The MRI showed bilateral oedema in a pattern compatible with PRES. There was clinical improvement after azathioprine suspension. PRES is typically reversible with prompt recognition of the syndrome and its trigger. The association with azathioprine is rare.

scholarly journals Malignant Posterior Reversible Encephalopathy Syndrome—An Exacting Challenge for Neurocritical Care Physicians

2017 ◽  
Vol 7 (4) ◽  
pp. 196-199 ◽  
Author(s):  
Shahvaiz Magsi ◽  
Atif Zafar
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Neurocritical Care ◽  
Bowel Resection ◽  
Resonance Imaging ◽  
Posterior Reversible Encephalopathy ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Resolution Of Imaging ◽  
Tomography Scan ◽  
Caucasian Female

We report a case of malignant posterior reversible encephalopathy syndrome (PRES) in a 62-year-old Caucasian female with a complex medical history and comorbidities admitted for bowel resection and lysis of iatrogenic bowel adhesions and enterocutaneous fistulas. Postoperatively, the patient developed sudden bilateral visual loss with no other neurologic deficits. Computed tomography scan showed very severe PRES-like changes, confirmed on magnetic resonance imaging (MRI). Systolic blood pressure remained around 170 mm HG. The patient was obtunded and remained unresponsive after MRI, with minimal response and a deteriorating clinical condition. The patient was given hyperosmolar therapy with a mannitol bolus. She recovered well with near resolution of imaging findings.

scholarly journals A Rare Case of Cyclophosphamide-Induced Posterior Reversible Encephalopathy Syndrome in a Patient with Anti-GBM Vasculitis, and Review of Current Literature

2019 ◽  
Vol 2019 ◽  
pp. 1-5 ◽  
Author(s):  
Taha Nisar ◽  
Abdul R. Alchaki ◽  
Erin Feinstein
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Sinus Thrombosis ◽  
Altered Mental Status ◽  
Cerebral Venous Sinus Thrombosis ◽  
Clinical Syndrome ◽  
Posterior Reversible Encephalopathy ◽  
Posterior Leukoencephalopathy ◽  
Vessel Imaging ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome of headache, altered mental status, and seizures with reversible mainly posterior leukoencephalopathy on neuroimaging. Precipitating factors for PRES are multifactorial and include autoregulatory failure due to changes in blood pressure, metabolic derangements, and cytotoxic medications. We report the second case of cyclophosphamide-induced PRES in a patient with anti-glomerular basement membrane (Anti-GBM) positive vasculitis. In the acute setting, PRES can be challenging to distinguish from cerebral venous sinus thrombosis or cerebral vasculitis based on clinical presentation. Neuroimaging with magnetic resonance imaging (MRI) of the brain along with a vessel imaging, can help reach the diagnosis.

Posterior reversible encephalopathy syndrome (PRES): presentation, diagnosis and treatment

2020 ◽  
Vol 96 (1140) ◽  
pp. 623-628 ◽  
Author(s):  
Anant Parasher ◽  
Rajat Jhamb
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Symptoms ◽  
Positive Outcome ◽  
Neurological Deficits ◽  
Posterior Reversible Encephalopathy ◽  
Mri Scans ◽  
Blood Pressures ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder which is characterised by variable symptoms, which include visual disturbances, headache, vomiting, seizures and altered consciousness. The exact pathophysiology of PRES has not been completely explained, but hypertension and endothelial injury seem to be almost always present. Vasoconstriction resulting in vasogenic and cytotoxic edema is suspected to be responsible for the clinical symptoms as well as the neuro-radiological presentation. On imaging studies, Symmetrical white matter abnormalities suggestive of edema are seen in the computer tomography (CT) and magnetic resonance imaging (MRI) scans, commonly but not exclusively in the posterior parieto-occipital regions of the cerebral hemispheres. The management is chiefly concerned with stabilization of the patient, adequate and prompt control of blood pressure, prevention of seizures and timely caesarean section in obstetric cases with pre-eclampsia/eclampsia. In conclusion, persistently elevated blood pressures remain the chief culprit for the clinical symptoms as well as the neurological deficits. Early diagnosis by diffusion weighted MRI scans, and differentiation from other causes of altered sensorium i.e. seizures, meningitis and psychosis, is extremely important to initiate treatment and prevent further complications. Although most cases resolve successfully and carry a favorable prognosis, patients with inadequate therapeutic support or delay in treatment may not project a positive outcome.

scholarly journals Good outcome after posterior reversible encephalopathy syndrome (PRES) despite elevated cerebral lactate: a case report

2015 ◽  
Vol 4 (6) ◽  
pp. 205846011557832 ◽  
Author(s):  
Caroline Ewertsen ◽  
Daniel Kondziella ◽  
Else R Danielsen ◽  
Carsten Thomsen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Vasogenic Edema ◽  
Resonance Imaging ◽  
Posterior Reversible Encephalopathy ◽  
Irreversible Brain Damage ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
The Brain ◽  
Elevated Lactate

Posterior reversible encephalopathy syndrome (PRES) may cause irreversible brain damage. The diagnosis is confirmed by magnetic resonance imaging (MRI), where vasogenic edema may be seen especially in the posterior parts of the brain. MR spectroscopy (MRS) may be included to help predict the outcome by measuring selected metabolites for instance lactate. Usually lactate is immeasurable in brain tissue, but elevates in cases of hypoxia, and it has been associated with poor outcome. We report a case of a patient with eclampsia and PRES, who had elevated lactate initially, but complete remission clinically and on MRI.

scholarly journals Posterior reversible encephalopathy syndrome and pregnancy: a Moroccan retrospective study of a patient’s oligo series

2021 ◽  
Vol 10 (10) ◽  
pp. 3942
Author(s):  
Aboubakr Benjilany ◽  
Jaouad Kouach
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Military Hospital ◽  
Lung Edema ◽  
Posterior Reversible Encephalopathy ◽  
Elevated Liver Enzymes ◽  
Low Platelet Count ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy ◽  
The Military ◽  
Visual Disturbances

Posterior reversible encephalopathy syndrome (PRES) is an entity combining reversible central nervous system damages with characteristic magnetic resonance imaging (MRI) brain imaging, it can occur in peripartum regardless of any preexisting pathology. PRES in peripartum is a poorly understood phenomenon. Early diagnosis and management are essential to prevent irreversible neurological sequelae. We report 6 cases series of PRES, collected at obstetrics and gynecology department of the military hospital Mohamed V in Rabat, between 2000 and 2019, in order to describe and analyze epidemiological, clinical, paraclinical and therapeutic aspects. Average age was 27 years old. Found symptoms were: high blood pressure, seizures, headaches, visual disturbances, consciousness disorders, vivid osteotendinous reflexes, vertigo, nausea and vomiting. Associated complications were status epilepticus, eclampsia, haemolysis, elevated liver enzymes, low platelet count (HELLP) syndrome and acute lung edema. Radiologically, found lesions are suggestive of PRES. After management, evolution was favorable in all patients. 

scholarly journals Neurotoxic complications of chemotherapy in children: posterior reversible encephalopathy syndrome

2021 ◽  
Vol 20 (5) ◽  
pp. 50-56
Author(s):  
O. V. Koryakina ◽  
O. P. Kovtun ◽  
L. G. Fechina ◽  
I. S. Tereshchenko ◽  
R. S. Volozhanin
Keyword(s):  
Posterior Reversible Encephalopathy Syndrome ◽  
Clinical Manifestations ◽  
Posterior Reversible Encephalopathy ◽  
Clinical Observations ◽  
Oncological Diseases ◽  
Triggering Factor ◽  
Radiological Aspect ◽  
Medical Histories ◽  
Magnetic Resonance Imaging Mri ◽  
Reversible Encephalopathy

Introduction. The syndrome of posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological condition caused by vasogenic brain edema due to elevated blood pressure. The development of this syndrome is associated with the toxic effect of drugs in the treatment of oncological diseases. In most cases, timely diagnosis and therapy of PRES determine the complete reversibility of symptoms. However, a poor prognosis is possible with the development of severe disabling consequences or death. In practice, there are difficulties in the diagnosis of PRES due to the lack of specificity of clinical manifestations and awareness of many doctors about the existence of this syndrome.The aim of the study was to present the clinical-radiological aspect of the syndrome of posterior reversible encephalopathy in children with oncological diseases.Materials and methods. The analysis of 8 medical histories of children with oncological pathology complicated by the syndrome of posterior reversible encephalopathy was carried out.Results. The study group was dominated by patients with hemato-oncological diseases. The development of PRES occurred during chemotherapy and in most cases was not associated with arterial hypertension. The clinical picture was dominated by such symptoms as impairment of consciousness, seizures and movement disorders in the form of paresis. When carrying out magnetic resonance imaging (MRI), the lesion of the white matter of the brain was determined, mainly in the projection of the parieto-occipital regions. During treatment, all patients showed reversibility of neurological symptoms with leveling of radiological signs.Discussion. When analyzing the clinical and radiological characteristics of PRES in children, a comparison of the data with clinical observations presented in the literature was noted. The role of chemotherapy as a triggering factor in the development of posterior reversible encephalopathy syndrome has been determined.Conclusion. The necessity of including the syndrome of posterior reversible encephalopathy in the list of differential diagnoses in patients receiving chemotherapy is shown.

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