title: Posterior reversible encephalopathy associated with nocturnal blood pressure non-dipping pattern.
abstract: We report the case of a 70-year-old man who presented with a recent history of headache, altered mental status and sleepiness. He was known to have type II diabetes mellitus, and a mild, treated and apparently well controlled hypertension. Brain magnetic resonance imaging demonstrated extensive abnormalities in the parieto-occipital white matter, suggestive of posterior reversible encephalopathy syndrome (PRES). An extensive diagnostic evaluation did not allow the detection of any known cause of the syndrome. Twenty-four-hour non-invasive ambulatory blood pressure monitoring showed a mild to moderate hypertension, with non-dipping pattern. This case suggests that, in the context of an overnight blunted blood pressure profile, even a mild or moderate hypertension can result in cerebral vasogenic oedema, underlining the diagnostic importance of 24-h blood pressure monitoring in patients with PRES without severe hypertension or other commonly recognized causes of posterior reversible encephalopathy.
authors.affiliation: Section of Neurology, University of Ferrara , Italy.
authors.forename: Ilaria
authors.initials: I
authors.lastname: Casetta
authors.forename: Edward
authors.initials: E
authors.lastname: Cesnik
authors.forename: Francesco
authors.initials: F
authors.lastname: Pedelini
mesh_terms: D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D020343:Hypertensive Encephalopathy / Q000503:physiopathology* / Q000628:therapy; D008297:Male; D054038:Posterior Leukoencephalopathy Syndrome / Q000503:physiopathology* / Q000628:therapy