Posterior Reversible Encephalopathy Syndrome (PRES)

posterior reversible encephalopathy syndrome

This patient presented encephalopathic and very hypertensive. The bilateral occipital high signal on FLAIR was considered consistent with PRES. Followup scan two weeks later, after blood pressure control and resolution of symptoms, there was resolution of radiological findings also.

Oedema typically in occipital lobes bilateraly, seen in many clinical settings as a result of break down of the blood brain barrier.

Severe hypertension
– Post partum
– Eclampsia / preeclampsia
– Acute glomerulonephritis
Haemolytic uraemic syndrome (HUS)
Thrombocytopaenic thromboic purpura (TTP)
Systemic lupus erythromatosis (SLE)
Drug toxicity
– Cisplatin
– Interferon
– Erythropoietin
– Tacrolimus
– Cyclosporin

For a followup image demonstrating resolution of changes please visit Radiopaedia.or here.

Credit: Dr Frank Gaillard