title: Clinical and radiological spectrum of posterior reversible encephalopathy syndrome: does age make a difference?--A retrospective comparison between adult and pediatric patients.
abstract: BACKGROUND
  Posterior reversible encephalopathy syndrome (PRES) is a serious and increasingly recognized disorder, but data from observational studies on clinicoradiological differences between etiologies and age groups are limited. In this study, we aimed to investigate the clinical and imaging characteristics of PRES in children compared to adults in a large cohort.
  
  
  METHODS
  We retrospectively reviewed the radiological report data bases between January 1999 and August 2012 for patients with PRES (total of 110 patients). Patients fulfilling the criteria for PRES after detailed investigation of clinical charts and imaging studies were separated into children (<18 years) and adults (≥18 years). Various imaging features at onset of symptoms and on follow-up as well as clinical and paraclinical data were analyzed.
  
  
  RESULTS
  A total of 19 pediatric and 91 adult patients with PRES were included into the study. In pediatric PRES patients, seizures were significantly more frequent as initial PRES-related symptom (p = 0.01). In addition, in children the superior frontal sulcus topographic lesion pattern occurred as frequent as the parieto-occipital one and was significantly more prevalent than in adults (p = 0.02). In contrast, in adults visual disturbances tended to occur more frequently than in children (p = 0.05). Also, severity of edema tended to be greater in adults than in children (p = 0.07).
  
  
  CONCLUSIONS
  In our PRES cohort, we found relevant clinicoradiological differences between pediatric and adult PRES patients. However, prospective studies are warranted to establish factors that are specifically associated with pediatric PRES.
authors.affiliation: Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Eberhard
authors.initials: E
authors.lastname: Siebert
authors.affiliation: Department of Neuroradiology, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Georg
authors.initials: G
authors.lastname: Bohner
authors.affiliation: Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany; German Center for Cardiovascular Research (DZHK) Partner Site, Charité - Universitätsmedizin Berlin, Berlin, Germany; German Center for Neurodegenerative Diseases (DZNE) Partner Site, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Endres
authors.affiliation: Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany; Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Liman
mesh_terms: D000328:Adult; D000367:Age Factors; D001921:Brain / Q000473:pathology; D001929:Brain Edema / Q000473:pathology*; D002648:Child; D005260:Female; D006801:Humans; D006973:Hypertension / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D054038:Posterior Leukoencephalopathy Syndrome / Q000000981:diagnostic imaging* / Q000473:pathology*; D011859:Radiography; D012189:Retrospective Studies; D012640:Seizures / Q000473:pathology*; D055815:Young Adult