Posterior reversible encephalopathy syndrome (PRES)

Case contributed by Dr Paul Simkin

Presentation

Seizures in the setting of recent bone marrow transplantation.

Patient Data

Age: 25
Gender: Female

There are T2 high signal lesions within the cortex and subcortical region of both parietal and occipital lobes. There is associated gyral swelling. There is also involvement of the left posterior temporal lobe and the cortex of the pre-and post central gyri bilaterally.

No associated restricted diffusion. No susceptibility artefact to indicate underlying haemorrhage. No underlying lesions.

Conclusion

The appearances favour posterior reversible encephalopathy syndrome (PRES) either directly related to bone marrow transplantation or one of many drugs.

Case Discussion

While first described in the setting of eclampsia and hypertension, it is also well documented in the setting of post-transplantation immunosuppresion and cyclosporin.

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Case information

rID: 30476
Case created: 13th Aug 2014
Last edited: 17th Dec 2015
Inclusion in quiz mode: Included

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