Клинический случай синдрома задней обратимой энцефалопатии у пациентки молодого возраста

Abstract

Posterior reversible encephalopathy syndrome (PRES) is characterized by a spectrum of neurological and radiological features. The article presents a clinical report of the posterior reversible encephalopathy syndrome developed due to cerebral edema caused by vasorenal hypertension, uremia, and kidney pathology in a young female patient. The clinical manifestations were characterized by a combination of general cerebral and focal neurological symptoms as the severe cephalgia with nausea and vomiting; psychomotor agitation; convulsive syndrome; visual disorders. Neurological symptoms required a differential diagnosis with a wide range of conditions, including venous stroke, ischemic stroke in the vertebrobasilar system, subarachnoid hemorrhage, viral encephalitis, demyelinating diseases, toxic damage of the nervous system. The magnetic resonance imaging examination revealed the presence of vasogenic edema in the white matter of the occipital, parietal, frontal lobes, and in the medulla oblongata. The regression of neurological symptoms on the second day of hospitalization occurred due to the antihypertensive, anticonvulsant therapy, correction of electrolyte disorders. In the diagnosis of posterior reversible encephalopathy syndrome, magnetic resonance imaging of the brain is informative, revealing areas of vasogenic edema, mainly localized in the occipital and parietal lobes, sometimes extending to the frontal lobes and the brain stem.