Clinical and hnaghtg features of reversible posterior leukoencepha- lopathy syndrome： a retrospective study of 9 cases

Abstract

Objective To investigate the clinical and imaging features of the reversible posterior leukoencephalopathy syndrome （RPLS）. Methods The clinical and imaging data of 9 patients with RPLS were analyzed retrospectively. Results Among the patients, 4 （44%） were secondary to pregnancy-induced hypertension syndrome, 1 （11% ） was second to short bowel syndrome, 1（11% ） was second to acute lymphoblastic leukemia, 1 （ 11% ） was second to IgA nephropathy, and 2 （22%） were second to hypertensive encephaiopathy. Their mean age of symptom onset was 23.4 ＋-9. 9 years. Their main clinical manifestations were headaches, seizures, blurred vision, and consciousness disturbance. Magnetic resonance imaging （MRI） showed symn~trical lesions of bilatered white matter in posterior brain. T1 weighted imat~g and diffusion-weighted imaging showed low or isointense signal. T2 weighted imaging, fluid attenuated inversion recovery （FLAIR）, and apparent diffusion coefficient （ADC） map showed high-intensi- ty signal. The symptoms of the patients disappeared after the treatment. MR/ reexamination showed that the lesions disappeared completely or almost completely. Conclusions The causes of RPLS were different. The imaging mainly showed the signal of vasogenic brain edema on the posterior white matter of the brain. After timely treatment, the symptoms and imaging features were improved rapidly. The patients with young-onset RPLS are their important clinical feature. Key words: Posterior leukoencephalopathy syndrome; Magnetic resonance imagingHypertension; Age factors