title: Posterior reversible encephalopathy syndrome: clinicoradiological spectrum and therapeutic strategies.
abstract: Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome of encephalopathy, headache, visual disturbance, and seizures. In most cases, symptoms present acutely or subacutely in the setting of accelerated hypertension, eclampsia, autoimmune disease, immunosuppressive treatment, or cancer chemotherapy. One essential feature of PRES is the presence of reversible cerebral vasogenic edema that has a predominantly posterior distribution on brain imaging. Atypical imaging features are commonly described, including involvement of the anterior brain or brainstem and the coexistence of ischemia or hemorrhage. In most cases, both clinical and radiological findings are reversible, although permanent imaging abnormalities and residual neurological sequelae can be seen in a minority of patients. The syndrome is thought to be caused by a breakdown of the blood-brain barrier and an extravasation of the intravascular fluid. Treatment of hypertension and seizures, and withdrawal of causative agents are the mainstays of therapy in PRES.
authors.affiliation: Physician, Division of Neurology, Department of Medicine, Lehigh Valley Health Network, Allentown, PA 18103, USA.
authors.forename: Yuebing
authors.initials: Y
authors.lastname: Li
authors.forename: Donna
authors.initials: D
authors.lastname: Jenny
authors.forename: John
authors.initials: J
authors.lastname: Castaldo
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure; D001812:Blood-Brain Barrier / Q000737:chemistry / Q000503:physiopathology; D001921:Brain / Q000000981:diagnostic imaging*; D001929:Brain Edema / Q000000981:diagnostic imaging; D002545:Brain Ischemia / Q000175:diagnosis / Q000209:etiology; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000502:physiology; D003937:Diagnosis, Differential; D006801:Humans; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000209:etiology; D008279:Magnetic Resonance Imaging; D059906:Neuroimaging / Q000379:methods*; D054038:Posterior Leukoencephalopathy Syndrome / Q000175:diagnosis* / Q000503:physiopathology* / Q000628:therapy; D012307:Risk Factors; D012640:Seizures / Q000188:drug therapy / Q000209:etiology; D014057:Tomography, X-Ray Computed
chemical_list: D000927:Anticonvulsants; D000959:Antihypertensive Agents