Posterior reversible encephalopathy syndrome (PRES) is associated with what conditions?
PRES is a clinical-radiological syndrome associated with a variety of complex conditions such as preeclampsia/eclampsia, autoimmune disease, high dose cancer chemotherapy, after allogeneic bone marrow transplantation, solid organ transplantation, renal failure, and hypertension.
What are the clinical manifestations of PRES?
It has a broad spectrum of clinical manifestations as headache, blurred vision, hemianopsia, nausea/vomiting, seizure, encephalopathy, consciousness impairment, focal neurological signs, paresis, and coma.
What are the typical imaging findings of this disease?
The typical findings are symmetric vasogenic edema affecting the parietooccipital cortex and subcortical white matter, which may manifest as hypodense areas on CT and hyperintensities on T2/FLAIR on MRI.
What are other imaging findings of PRES?
PRES sometimes extend from the posterior to other parts of the brain such as the frontal and temporal lobes, basal ganglia, brain stem, and cerebellum. It sometimes progresses to atypical appearances including unilateral abnormalities, hemorrhage, contrast enhancement or diffusion-weighted restriction, which is usually potentially reversible.
Magnetic resonance imaging (MRI) demonstrates the bilateral cortex and subcortical white matter T2/Fluid-attenuated inversion recovery (FLAIR) hyperintensities in the posterior parietal lobes, which correspond to vasogenic edema, suggestive of PRES. The edema distribution is in the posterior cerebral artery (PCA) regions. MR diffusion-weighted imaging (DWI) confirms that the area of abnormality represents vasogenic edema, without restricted diffusion.