Posterior reversible encephalopathy syndrome in intensive care medicine.
BACKGROUND
Posterior reversible encephalopathy syndrome (PRES) is a well-recognized clinico-neuroradiological transient condition. Early recognition is of paramount importance for prompt control of blood pressure or removal of precipitating factors and treatment of epileptic seizures or status epilepticus. Delay in the diagnosis and treatment may in fact results in death or in irreversible neurological sequelae.


CONCLUSIONS
PRES is characterized by headache, altered mental status, seizures, and visual disturbances and is associated with a number of different causes, most commonly acute hypertension, preeclampsia/eclampsia, and immunosuppressive agents. Clinical symptoms and neuroradiological findings are typically indistinguishable among the cases of PRES, regardless of underlying cause. Magnetic resonance studies typically show edema involving the white matter of cerebral posterior regions, especially parieto-occipital lobes but frontal and temporal lobes, and other encephalic structures may be involved.


CONCLUSIONS
Intensivists and other physicians involved in the evaluation of patients with presumed PRES must be aware of the clinical spectrum of the associated conditions, the diagnostic modalities, and the correct treatment.
Servillo
Giuseppe
G
Medical Intensive Care Unit, Department of Surgical and Anesthesiological Sciences, Naples, Italy. servillo@unina.it
Bifulco
Francesca
F
De Robertis
Edoardo
E
Piazza
Ornella
O
Striano
Pasquale
P
Tortora
Fabio
F
Striano
Salvatore
S
Tufano
Rosalba
R
D001794:Blood Pressure; D003422:Critical Care; D003937:Diagnosis, Differential; D006801:Humans; D020343:Hypertensive Encephalopathy / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D008279:Magnetic Resonance Imaging; D013226:Status Epilepticus / Q000188:drug therapy