Phenylephrine Induced Posterior Reversible Encephalopathy Syndrome during Resection of Solitary Pulmonary Nodule

• Main Authors: Soon Ho Hong, Yun Kyung Park, Bora Yoon, Kee Ook Lee, Yong-Duk Kim, Sang-Jun Na
• Format: Article
• Language: English
• Published: The Korean Neurocritical Care Society 2017-06-01
• Series: Journal of Neurocritical Care
• Subjects: Posterior reversible encephalopathy syndrome; Phenylephrine; Hypertension
• Online Access: http://www.e-jnc.org/upload/pdf/jnc-170005.pdf
• ISSN: 2005-0348; 2508-1349

Background Posterior reversible encephalopathy syndrome (PRES) is a neurological complication caused by cerebral hyperperfusion. Case Report A 46-year-old male presented with decreased mental status, left facial palsy, and left-sided weakness after video-assisted thoracoscopic surgery for a solitary pulmonary nodule. During the surgery, phenylephrine was infused intravenously for general anesthesia-induced hypotension. High signal intensity at the right parietooccipital lobe was noted on fluid-attenuated inversion recovering imaging and diffusion-weighted imaging. His neurological symptoms improved two days after initial presentation. Follow-up diffusion-weighted imaging showed resolution of the brain lesions 10 days after the surgery. Conclusions We report a patient who presented with PRES after administration of phenylephrine during resection of a solitary pulmonary nodule. PRES should be considered for patients presented with acute neurologic symptoms following surgical procedures.