Abstract
We present the case of a 33-year-old male with end stage renal disease presenting to the emergency department (ED) with headache, dizziness, and unilateral weakness. Initial concern was for ischemic or hemorrhagic stroke. Magnetic resonance imaging confirmed posterior reversible encephalopathy syndrome (PRES). The patient was treated appropriately and made a full neurologic recovery. PRES is an under-recognized diagnosis in the ED. As a stroke mimic, PRES can lead the clinician on an incorrect diagnostic pathway with potential for iatrogenic harm.
Highlights
We present the case of a 33-year-old male with end stage renal disease presenting to the emergency department (ED) with headache, dizziness, and unilateral weakness
Posterior reversible encephalopathy syndrome (PRES) is a neurologic condition characterized by localized vasogenic edema primarily affecting the occipital and parietal lobes.[1]
A noncontrast computerized tomography (CT) of the head is of little benefit and magnetic resonance imaging (MRI) of the brain is necessary to demonstrate vasogenic edema and other pathognomonic findings
Summary
University of Louisville School of Medicine, Department of Emergency Medicine, Louisville, Kentucky. We present the case of a 33-year-old male with end stage renal disease presenting to the emergency department (ED) with headache, dizziness, and unilateral weakness. Initial concern was for ischemic or hemorrhagic stroke. Magnetic resonance imaging confirmed posterior reversible encephalopathy syndrome (PRES). The patient was treated appropriately and made a full neurologic recovery. PRES is an under-recognized diagnosis in the ED. PRES can lead the clinician on an incorrect diagnostic pathway with potential for iatrogenic harm. PRES can lead the clinician on an incorrect diagnostic pathway with potential for iatrogenic harm. [Clin Pract Cases Emerg Med. 2017;1(3):171–174.]
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