Abstract
Posterior reversible encephalopathy syndrome (PRES) is a condition clinically characterized by headache, altered mental status, seizures, and visual loss and may be associated with systemic hypertension, preeclampsia/eclampsia, chemotherapy, immunosuppressive therapies in the setting of organ transplantation, and uremic encephalopathy. While brain imaging in patients with PRES typically reveals symmetric vasogenic edema within the parietal and occipital lobes, PRES may present with atypical imaging findings such as central brainstem and deep gray involvement without subcortical edema, and even spinal cord involvement. Additionally, PRES may be complicated in some cases by the presence of cytotoxic edema and hemorrhage. This review will serve to summarize the pathophysiologic theories and controversies underlying PRES, imaging features encountered in atypical and complicated PRES, and the implications these findings may have on patient prognosis.
Highlights
Posterior reversible encephalopathy syndrome (PRES) is a syndrome affecting the CNS with a range of clinical presentations, most often including headache, altered mental status, seizures, and visual loss
A multitude of conditions may lead to the development of PRES, with most common etiologies reported including moderate to severe hypertension, preeclampsia/eclampsia, infection with sepsis and shock, autoimmune disease such as systemic lupus erythematosus, multidrug chemotherapy regimens most often in the setting of hematopoietic malignancies, and in the setting of bone marrow and stem cell transplantation [2]
The typical CT and MRI imaging features encountered in the setting of PRES consist of near symmetric hemispheric vasogenic edema affecting subcortical white matter and often extending to involve overlying cortex, best demonstrated with FLAIR sequences [3]
Summary
Reviewed by: Chuanming Li, Chongqing Medical University, China Xudong Shen, Guizhou Medical University (GMU), China. Posterior reversible encephalopathy syndrome (PRES) is a condition clinically characterized by headache, altered mental status, seizures, and visual loss and may be associated with systemic hypertension, preeclampsia/eclampsia, chemotherapy, immunosuppressive therapies in the setting of organ transplantation, and uremic encephalopathy. While brain imaging in patients with PRES typically reveals symmetric vasogenic edema within the parietal and occipital lobes, PRES may present with atypical imaging findings such as central brainstem and deep gray involvement without subcortical edema, and even spinal cord involvement. PRES may be complicated in some cases by the presence of cytotoxic edema and hemorrhage. This review will serve to summarize the pathophysiologic theories and controversies underlying PRES, imaging features encountered in atypical and complicated PRES, and the implications these findings may have on patient prognosis
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
