Posterior reversible encephalopathy syndrome

Case contributed by Ahmed Abdrabou
Diagnosis almost certain


Acute confusion and headache. History of recent cesarean section.

Patient Data

Age: 25 years
Gender: Female

Bilateral symmetrical altered signal intensity of the subcortical white matter of occipital, parietal, posterior temporal and extending to the frontal lobes. they display bright signal on T2 and FLAIR, low T1 signal, no restriction of diffusion on DWI yet there is T2 shine through effect and no significant enhancement on post contrast scan. No significant mass effect. 

Case Discussion

The clinical history and MR findings are classic for PRES which can involve the anterior circulation as well making it a misnomer. The patient received steroids and responded well.

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