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Academia Mexicana de Neurología, A.C.

2010, Number 5

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Rev Mex Neuroci 2010; 11 (5)

Posterior reversible encephalopathy syndrome: Not always reversible and not necessarily confined to the posterior regions of the brain

Saniger AMM, Rodríguez BR, Arévalo OVH

Language: Spanish
References: 21
Page: 373-377
PDF size: 158.48 Kb.


ABSTRACT

Posterior reversible encephalopathy syndrome (PRES) is recently described neurologic condition characterized by headache, seizures and visual loss, often coupled with an abrupt increase in blood pressure, and associated with a unique MRI appearance which comprises an essential component of the diagnosis of PRES. Typical lesions predominate in the posterior white matter, with some involvement of the overlying cortex; are hyperintense on T2-weighted images; and are usually hypointense or isointense on diffusion-weighted images, with an increase of the apparent diffusion coefficient, indicating vasogenic edema. The pathogenesis is incompletely understood, although it seems to be related to the breakthrough of autoregulation and endothelial dysfunction. It is associated with a number of complex conditions (preeclampsia/eclampsia, allogenic bone marrow transplantation, organ transplantation, autoimmune disease and high dose chemotherapy). The term reversible posterior leukoencephalopathy is a misnomer as the condition is not always reversible, is not necessarily confined to the posterior regions of the brain and can affect both white and grey matter. This review summarizes the basic and advanced imaging features of PRES, along with pertinent features of the clinical presentation and management.


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