PRES with underlying thrombotic thrombocytopenic purpura

Case contributed by Emmanouil Kalioras


Known thrombotic thrombocytopenic purpura, hypertension, seizures.

Patient Data

Age: 50 years
Gender: Female

Bilateral areas of T2 hyperintesinty involving the white, as well as the grey matter of the frontal, parietal and occipital lobes.

Facilitated diffusion in the affected areas, indicative of vasogenic edema.

Bilateral T2 hyperintensities involving the midbrain and pons.

No sign of signal loss on SWI images.

No sign of dural venous sinus thrombosis.

2 months after treatment


Absence of previously mentioned T2 hyperintensities.

Case Discussion

In this patient thrombotic thrombocytopenic purpura (TTP) caused renal insuffiency resulting in hypertension.

After blood pressure regulation MRI findings and neurological symptoms disappeared, supporting the case of posterior reversible encephalopathy syndrome (PRES).

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