Presentation
Acute post-infectious glomerulonephritis secondary to streptococcal pharyngotonsillitis, where he reported blood pressure levels of 150/100 mmHg post-antibiotic therapy and antihypertensives. New-onset seizures and altered mental status.
Patient Data
In the cuneus of the occipital cortex, there is heterogeneous signal intensity, predominantly demonstrating low signal on T1 and high signal on T2/FLAIR, without diffusion restriction.
There is a susceptibility artifact on SWI with cortical and subcortical involvement. On post-contrast images, there is significant gyriform enhancement, which extends from the tentorium to the inferior parietal lobes.
Case Discussion
Children with posterior reversible encephalopathy syndrome typically present with a sudden onset of neurological symptoms, such as seizures, visual disturbances, headaches, and altered mental status. Focal or generalised seizures are the most common symptom, accounting for approximately 90% of children with PRES.
Posterior reversible encephalopathy syndrome is a complex clinical-radiological syndrome characterised by acute neurological symptoms such as seizures and potentially reversible parieto-occipital vasogenic oedema in brain MRI. It is caused by cerebral endotheliopathy with subsequent disruption of vasogenic oedema. It occurs in specific settings such as abrupt hypertension, renal disorders, the use of immunosuppressive drugs, or following organ transplantation. Brain MRI is crucial for diagnosing PRES, but validated diagnostic criteria have yet to be established. If the underlying cause is removed in the early phase.
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