Posterior reversible encephalopathy syndrome and splenial lesion
46 years old female with sudden onset cortical blindness.
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T2 and FLAIR images shows high signal intensities in both occipital lobes. Interestingly DWI and ADC map demonstrate a focal area of restricted diffusion in the splenium of corpus callosum. No restricted diffusion seen in the occipital lobes. No enhancement demonstrated on the post contrast T1 examination.
MRI TOF and venogram are both unremarkable.
Coexistance of PRES and restricted diffusion in the splenium of corpus callosum highlights the potential possibility of vasoconstriction of the pericollasal branches supplying the splenium arising from the posterior cerebral artery.
Unfortunately no follow-up imaging was performed to document if these changes were transient, but reversible splenial lesion has been reported to be associated with a wide range of aetiologies, however is extremely rare in setting of PRES.