Staykov D, Schwab S
Neurologische Klinik, Universitätsklinikum Erlangen, Schwabachanlage 6, 91054 Erlangen, Deutschland.
Nervenarzt. 2012 Aug;83(8):1013-20. doi: 10.1007/s00115-012-3480-2.
Posterior reversible encephalopathy syndrome (PRES) is a clinically and radiologically defined syndrome characterized by seizures, headaches, visual disturbances, and altered mental status or focal neurological deficits. Imaging frequently shows abnormalities in the posterior brain regions, especially the occipital and the parietal lobes. PRES has been described in association with a wide spectrum of underlying causes. The most common conditions include hypertension, renal disease, preeclampsia/eclampsia, or status post transplantation. The pathophysiology of PRES has not been sufficiently elucidated as yet; however, endothelial damage caused by different mechanisms possibly plays a central role. The prognosis of PRES is usually benign when intensive care and withdrawal of the causative agent is instituted early. Delay in diagnosis and treatment may lead to complications and permanent neurological deficits. The clinical and radiological landmarks of this syndrome as well as causes, pathophysiological hypotheses, and the basic therapeutic principles of PRES are the subject of the present review.
后部可逆性脑病综合征(PRES)是一种临床和影像学定义的综合征,其特征为癫痫发作、头痛、视觉障碍、精神状态改变或局灶性神经功能缺损。影像学检查常显示后脑区域异常,尤其是枕叶和顶叶。PRES已被描述与多种潜在病因相关。最常见的情况包括高血压、肾脏疾病、先兆子痫/子痫或移植后状态。PRES的病理生理学尚未得到充分阐明;然而,不同机制引起的内皮损伤可能起核心作用。当早期进行重症监护并停用致病因素时,PRES的预后通常良好。诊断和治疗延迟可能导致并发症和永久性神经功能缺损。本综述的主题是该综合征的临床和影像学特征以及PRES的病因、病理生理假说和基本治疗原则。