Hedna Vishnumurthy Shushrutha, Stead Latha Ganti, Bidari Sharathchandra, Patel Akhil, Gottipati Amareshwari, Favilla Christopher G, Salardini Arash, Khaku Aunali, Mora Diana, Pandey Ajay, Patel Het, Waters Michael F
Department of Vascular Neurology, University of Florida, Archer Road, Gainesville, Florida, 32611, USA.
Int J Emerg Med. 2012 Feb 29;5:12. doi: 10.1186/1865-1380-5-12.
Posterior reversible encephalopathy syndrome (PRES) can present with focal neurologic deficits, mimicking a stroke and can often represent a diagnostic challenge when presenting atypically. A high degree of suspicion is required in the clinical setting in order to yield the diagnosis. Cerebral CT perfusion (CTP) is utilized in many institutions as the first line in acute stroke imaging. CTP has proved to be a very sensitive measure of cerebral blood flow dynamics, most commonly employed to delineate the infarcted tissue from penumbra (at-risk tissue) in ischemic strokes. But abnormal CTP is also seen in stroke mimics such as seizures, hypoglycemia, tumors, migraines and PRES. In this article we describe a case of PRES in an elderly bone marrow transplant recipient who presented with focal neurological deficits concerning for a cerebrovascular accident. CTP played a pivotal role in the diagnosis and initiation of appropriate management. We also briefly discuss the pathophysiology of PRES.
后部可逆性脑病综合征（PRES）可表现为局灶性神经功能缺损，类似中风，非典型表现时常常构成诊断挑战。临床环境中需要高度怀疑才能做出诊断。许多机构将脑CT灌注（CTP）用作急性中风成像的一线检查。CTP已被证明是测量脑血流动力学的非常敏感的方法，最常用于在缺血性中风中区分梗死组织和半暗带（高危组织）。但在癫痫、低血糖、肿瘤、偏头痛和PRES等类似中风的疾病中也可见到CTP异常。在本文中，我们描述了一例老年骨髓移植受者发生PRES的病例，该患者表现出令人担忧的局灶性神经功能缺损，疑似脑血管意外。CTP在诊断和启动适当治疗中起了关键作用。我们还简要讨论了PRES的病理生理学。
