Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndrome

• Main Authors: P Ricardo Pereira, João Pinho, Margarida Rodrigues, João Rocha, Filipa Sousa, José Amorim, Manuel Ribeiro, Jaime Rocha, Carla Ferreira
• Format: Article
• Language: English
• Published: Academia Brasileira de Neurologia (ABNEURO) 2015-01-01
• Series: Arquivos de Neuro-Psiquiatria
• Subjects: síndrome de encefalopatia posterior reversível; edema vasogénico; hipertensão arterial
• Online Access: http://www.scielo.br/scielo.php?script=sci_arttext&pid=S0004-282X2015000100036&lng=en&tlng=en

ObjectiveAnalyze the cases of posterior reversible encephalopathy syndrome (PRES) admitted in a Neurology Department during an 8-year period.MethodRetrospective observational study in a central hospital in the north of Portugal.Results14 patients were identified, mean age 52.3 years. Precipitating factors included: eclampsia, isolated arterial hypertension, spinal trauma and autonomic dysreflexia, Guillain-Barré syndrome, sepsis, sarcoidosis and pulmonary cryptococcosis and drugs. Most patients presented posterior-predominant vasogenic edema lesions, however 64.2% presented frontal lesions and in 42.8% cerebellum was involved. Four patients also had acute ischemic lesions and 1 had hemorrhagic lesions. During follow-up 10 patients recovered fully, 2 recovered partially, 1 suffered a recurrence and 2 died in hospital.ConclusionPRES has many etiological factors. The terms posterior and reversible should be revised because PRES frequently involves other brain regions and it is not always reversible. PRES patients may develop life-threatening complications and mortality is not negligible.