Li Yuebing, Jenny Donna, Castaldo John
Physician, Division of Neurology, Department of Medicine, Lehigh Valley Health Network, Allentown, PA 18103, USA.
Hosp Pract (1995). 2012 Feb;40(1):202-13. doi: 10.3810/hp.2012.02.961.
Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome of encephalopathy, headache, visual disturbance, and seizures. In most cases, symptoms present acutely or subacutely in the setting of accelerated hypertension, eclampsia, autoimmune disease, immunosuppressive treatment, or cancer chemotherapy. One essential feature of PRES is the presence of reversible cerebral vasogenic edema that has a predominantly posterior distribution on brain imaging. Atypical imaging features are commonly described, including involvement of the anterior brain or brainstem and the coexistence of ischemia or hemorrhage. In most cases, both clinical and radiological findings are reversible, although permanent imaging abnormalities and residual neurological sequelae can be seen in a minority of patients. The syndrome is thought to be caused by a breakdown of the blood-brain barrier and an extravasation of the intravascular fluid. Treatment of hypertension and seizures, and withdrawal of causative agents are the mainstays of therapy in PRES.
后部可逆性脑病综合征（PRES）是一种以脑病、头痛、视觉障碍和癫痫发作为特征的临床综合征。在大多数情况下，症状在加速性高血压、子痫、自身免疫性疾病、免疫抑制治疗或癌症化疗的背景下急性或亚急性出现。PRES的一个基本特征是存在可逆性脑血管源性水肿，在脑成像上主要分布于后部。非典型成像特征也较为常见，包括前脑或脑干受累以及缺血或出血并存。在大多数情况下，临床和影像学表现都是可逆的，尽管少数患者可见永久性成像异常和残留神经后遗症。该综合征被认为是由血脑屏障破坏和血管内液体外渗所致。控制高血压和癫痫发作以及停用致病药物是PRES治疗的主要方法。
