Posterior reversible encephalopathy syndrome

Case contributed by Fatiha Kharroubi
Diagnosis certain

Presentation

The patient, with a history of severe preeclampsia, presented with eclamptic seizures, necessitating an emergency caesarean section. A postoperative CT scan of the brain was performed.

Patient Data

Age: 30 years
Gender: Female

Bilateral and symmetrical white matter hypodensities are predominantly observed in the parieto-occipital lobes. There is no evidence of haemorrhage or traumatic brain lesions.

Case Discussion

PRES, or posterior reversible encephalopathy syndrome, results from a neurotoxic condition caused by the posterior circulation's inability to auto-regulate in response to sudden fluctuations in blood pressure. This leads to hyperperfusion, disrupting the blood-brain barrier and resulting in vasogenic oedema. Typically, lesions are bilateral and symmetrical, observed in the parieto-occipital regions. With a clear clinical presentation, diagnosis can be easily confirmed through either a CT scan or an MRI.

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