Posterior Reversible Encephalopathy Syndrome: Study of Common Associations and Varying Imaging Features
Journal Title: International Journal of Anatomy Radiology and Surgery - Year 2018, Vol 7, Issue 3
Abstract
Introduction: Posterior Reversible Encephalopathy Synd-rome (PRES) is a clinically bewildering encephalopathy syndrome which can be encountered in emergency room or in an already hospitalised patient. Its occurrence and mechanisms have been widely published mainly in the population of patients with transplant necessitated immunosuppression and not many studies have been carried out in the setting of many other risk factors. Aim: To study the frequency of primary clinical conditions causing or associated with PRES in general radiology practice. To study the frequency and distribution of abnormal findings in specific regions of brain. Materials and Methods: Radiology database of a free-standing imaging center and a multi-specialty hospital was scrutinised for reports citing PRES, hypertensive encephalopathy, eclampsia, renal disorders or any state of neurotoxicity on brain imaging, between July 2011 and June 2015. Reports showing complete or partial PRES pattern on imaging during the clinical neurotoxic syndrome were included in the study. Results: Total 84 patients were identified with PRES, out of them 80 were adults (mean age- 40.48±13.03 years). Among them 56 were men, 24 were women. There were four children (mean age- 12±2.19 years; with renovascular hypertension due to Takayasu’s arteritis). Twenty patients were normotensive and four patients were positive for Human Immunodeficiency Virus (HIV). Conclusion: There are many causes and associations of PRES but all of them are ‘systemic’ in nature. Spectrum of these systemic diseases may vary in population/practice. Hypertension is not an absolute requirement for diagnosis of PRES though it is the strongest association. Non posterior (non parieto-occipital) locations being frequent it is advisable to drop ‘posterior’ component from its name.
Authors and Affiliations
Madhav Hegde, Naveen Raj MB
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