Un caso di encefalopatia posteriore reversibile (PRES), sindrome neurologica acuta da edema cerebrale reversibile su base multifattoriale

Translated title of the contribution: Posterior reversible encephalopathy syndrome (PRES), an acute neurological syndrome due to reversible multifactorial brain edema: A case report

Camilla Cicognani, Chiara Vezzadini, Stella Battaglia, Anna F. Marliani, Roberto Zoni

Research output: Contribution to journalArticle

Abstract

Background: The essential features of Posterior Reversible Encephalopathy Syndrome (PRES) are headache, mental changes, seizures, visual symptoms and often arterial hypertension. Brain RMN typically shows cortico-sottocortical parieto-occipital edema, with a bilateral and symmetric distribution. PRES develops in clinical conditions as hypertensive encephalopathy, preeclampsia/ eclampsia, autoimmune diseases, after transplantation, infections and as an adverse effect of immunosuppressive drugs or chemotherapy. It usually completely reverses with treatment, although permanent sequelae are possible in case of delayed or missed diagnosis. Case report: We describe the case of a transsexual (M-→F) and tetraplegie patient, admitted for neck and low back pain. She suddenly developed headache, confusion, seizures and severe hypertension with normal blood tests. RMN showed multiple cortico-sottocortical areas of vasogenic and ototoxic edema in temporo-occipital, parietal, frontal, and cerebellar regions. Soon after the beginning of the antihypertensive therapy, clinical recovery was observed, as well as the disappearance of edema at RMN. Discussion and conclusions: Although PRES is usually associated with definite pathological conditions, it is not always the case, as was for the patient here described, who had no predisposing factors in her past clinical history, and presented hypertension only in the acute phase of the syndrome. Since, moreover, PRES usually presents with acute non specific features and it can be misdiagnosed with other serious diseases, the clinician will be helped by the knowledge of this syndrome to promptly start diagnostic workup and treatments, and avoid permanent neurological deficits.

Original languageItalian
Pages (from-to)37-42
Number of pages6
JournalItalian Journal of Medicine
Volume4
Issue number1
DOIs
Publication statusPublished - Mar 2010

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Posterior Leukoencephalopathy Syndrome
Brain Edema
Edema
Hypertension
Headache
Seizures
Hypertensive Encephalopathy
Eclampsia
Hematologic Tests
Immunosuppressive Agents
Low Back Pain
Pre-Eclampsia
Diagnostic Errors
Causality
Antihypertensive Agents
Autoimmune Diseases
Neck
Therapeutics
Transplantation
Drug Therapy

ASJC Scopus subject areas

  • Medicine(all)

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Un caso di encefalopatia posteriore reversibile (PRES), sindrome neurologica acuta da edema cerebrale reversibile su base multifattoriale. / Cicognani, Camilla; Vezzadini, Chiara; Battaglia, Stella; Marliani, Anna F.; Zoni, Roberto.

In: Italian Journal of Medicine, Vol. 4, No. 1, 03.2010, p. 37-42.

Research output: Contribution to journalArticle

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