Abstract
The posterior reversible encephalopathy syndrome (PRES) is a heterogeneous clinical-radiological characterized by a combination of encephalopathy, altered mental status, epileptic seizures, visual disturbances, headache, and focal neurologic signs. Other neurologic deficits, such as ataxia, may occur. PRES can be found in a nonposterior distribution, mainly in watershed areas, including the frontal, inferior temporal, cerebellar, and brainstem regions. We present the case of a middle age male presenting with headache, dizziness, ataxia, and hypertensive emergency. PRES was suspected, and the diagnosis was confirmed by brain magnetic resonance imaging. Computerized tomography showed bilateral hypodensities of the cerebellar white matter with associated narrowing of the cortical sulci and basal cisterns. This case represents a rare presentation of PRES with unusual clinical and topographical involvement, such as brainstem and cerebellum.
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