Posterior reversible encephalopathy syndrome (PRES)

Case contributed by Subhan Iqbal
Diagnosis certain

Presentation

Postpartum hypertensive female, presented with headache and seizures. Now altered consciousness, Intracranial bleeding?

Patient Data

Age: 30 years
Gender: Female

T2 and FLAIR hyperintense signals in bilateral parieto-occipital lobes and bilateral high frontal lobes involving cortex and juxtacortical white matter with minimal focal areas of diffusion restriction in high vertex.

Case Discussion

In posterior reversible encephalopathy syndrome, there is vasogenic edema within the occipital and parietal regions, relating to the posterior cerebral artery supply. The edema is usually symmetrical. Despite being termed posterior, posterior reversible encephalopathy syndrome can be found in a non-posterior distribution, mainly in watershed areas, including within the frontal, inferior temporal, cerebellar, and brainstem regions. Both cortical and subcortical locations are affected.

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