Posterior reversible encephalopathy syndrome (PRES)

Case contributed by Dr Varun Babu

Presentation

Presented to the ER with new onset tonic clonic seizures 10 days post partum.

Patient Data

Age: 40 years old
Gender: Female

Urgent CT Brain plain study

Modality: CT

Subcortical and deep white matter scatter bilateral hypoattenuation involving predominantly both parietal and occipital lobes and also involving bifrontal deep white matter. 

MRI brain within 24 hours of admission

Modality: MRI
  • The corresponding CT areas appear T2 FLAIR hyperintense.
  • They do not enhance in post contrast study.
  • No diffusion restriction of the areas.  
  • The arterial and venous system is unremarkable. 

MRI brain (after 6 weeks)

Modality: MRI

Follow up MR imaging after 6 weeks shows complete resolution of the white matter signal changes seen earlier. 

Case Discussion

This is an example of a case presenting with new onset seizures post partum. The documentation of disappearance of all neuroparenchymal signal abnormalities in the follow up study confirms the diagnosis of posterior reversible encephalopathy syndrome (PRES). 

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Case Information

rID: 44646
Case created: 30th Apr 2016
Last edited: 2nd May 2016
Inclusion in quiz mode: Included

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