Posterior reversible encephalopathy syndrome (PRES)

Case contributed by Ahmed Abdrabou


Headache, nausea, vomiting, dizziness and blurring of vision. The patient underwent bone marrow transplantation 2 weeks ago

Patient Data

Age: 17 years
Gender: Female

Abnormal signal changes of the occipital and posterior parietal cortical and subcortical area displaying bright signal in T2 and FLAIR, low signal in T1 and bright signal in DWI and ADC (shine through effect) indicating vasogenic edema. No enhancement in post contrast study. MRV excluded the possibility of venous infarction.

Case Discussion

Posterior reversible encephalopathy syndrome occurs due to an abnormal sympathetic innervation of the posterior circulation which results in inability to control acute rise in blood pressure. Its pathology is related to vasogenic edema of occipital and posterior parietal region (posterior circulation territory). It is associated with several conditions e.g. severse hypertension, SLE, HUS, drug toxicity and following stem cell transplantation.

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