title: Prognostic factors in children with PRES and hematologic diseases.
abstract: OBJECTIVE
  Posterior reversible encephalopathy syndrome (PRES) is a clinical and radiological entity characterized by focal neurological signs, headache, confusion, and seizure, associated with transitory lesions in the posterior areas of the brain detectable with neuroimaging. Among children, one of the most common causes of PRES is cancer.
  
  
  METHODS
  In this review, we present the cases of 5 children developing PRES after stem cell transplantation for hematological disease and review all the cases reported in English literature to investigate outcomes and associated risk factors.
  
  
  RESULTS
  One hundred and eleven cases were reported. Hypertension was very frequent (80%). Clinical features included seizures (80.1%), headache (44.1%), visual disturbance (26.1%), and mental change (48.6%). EEG was abnormal in 27 of 32 patients. MRI revealed characteristic lesions in all patients even in early stages. Abnormal MRI findings in late stages were associated with neurological sequelae. Nineteen patients died (17.1%) of which 2 of PRES. Among alive patients, 17 had neurological sequelae. Four cases of PRES relapse were described.
  
  
  CONCLUSIONS
  Thus, all transplant recipients with symptoms consistent with PRES should be promptly recognized to avoid long-term complications or even death.
authors.affiliation: Department of Neurology, Perugia General Hospital and University of Perugia, Perugia, Italy. n.tambasco@libero.it.
authors.forename: N
authors.initials: N
authors.lastname: Tambasco
authors.affiliation: Pediatric Oncology Hematology Unit, Perugia General Hospital, Perugia, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Mastrodicasa
authors.affiliation: Department of Pediatrics, Perugia General Hospital and University of Perugia, Perugia, Italy.
authors.forename: C
authors.initials: C
authors.lastname: Salvatori
authors.affiliation: Department of Pediatrics, Perugia General Hospital and University of Perugia, Perugia, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Mancini
authors.affiliation: Department of Neurology, Perugia General Hospital and University of Perugia, Perugia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Romoli
authors.affiliation: Pediatric Oncology Hematology Unit, Perugia General Hospital, Perugia, Italy.
authors.forename: M
authors.initials: M
authors.lastname: Caniglia
authors.affiliation: Department of Neurology, Perugia General Hospital and University of Perugia, Perugia, Italy.|IRCCS Fondazione Santa Lucia, Roma, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Calabresi
authors.affiliation: Department of Pediatrics, University of L'Aquila, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Verrotti
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D017809:Fatal Outcome; D005260:Female; D006402:Hematologic Diseases / Q000150:complications / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000150:complications / Q000628:therapy; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D006973:Hypertension / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D054038:Posterior Leukoencephalopathy Syndrome / Q000150:complications / Q000000981:diagnostic imaging / Q000628:therapy*; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome
keywords: 
  EEG
  ; 
  PRES
  ; hematologic disease; neuroimaging; outcome; posterior reversible encephalopathy; seizure