Posterior reversible encephalopathy syndrome

Discussion:

Cross section imaging findings classical of PRES - with an appropriate associated clinical history.

Posterior reversible encephalopathy syndrome (PRES) (also known as hypertensive encephalopathy) is a neurotoxic state occurring secondary to the inability of posterior circulation to auto-regulate in response to acute changes in blood pressure. Hyperperfusion with resultant disruption of the blood brain barrier results in vasogenic oedema, most commonly in the parieto-occipital regions.

The blood product sensitive sequences show evidence of hypertensive microangiopathy, indicating an acute on chronic problem with blood pressure.

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