Department of Radiology, Yantai Yuhuangding Hospital, Yantai, Shandong, China.
Department of Neurology, Yantaishan Hospital of Yantai City, Yantai, Shandong, China.
J Neurol Neurosurg Psychiatry. 2018 Jan;89(1):14-20. doi: 10.1136/jnnp-2017-316225. Epub 2017 Aug 9.
Over two decades have passed since posterior reversible encephalopathy syndrome (PRES) was first described in 1996. It has becoming increasingly recognised because of improved and more readily available imaging modality. The exact pathophysiological mechanism is not completely understood and remains controversial at present. Precise diagnosis is essential to guide prompt, proper management. Our ability of differentiating it from other acute neurological disorders is likely to improve as we learnt more about the spectrum of this entity in the last 20 years. We emphasise the importance of recognising its diagnostic criteria and biomarker, which would be of great relevance to either outcome evaluation or study design. PRES has a favourable prognosis generally, but neurological sequelae and even fatalities can occur, especially in severe forms that might cause substantial morbidity and even mortality, particularly when the syndrome is complicated by intracranial haemorrhage or brain infarction. In this review, the pathophysiology, approach to diagnosis, some controversies as to the prognosis, as well as the future research direction of PRES are described.
自 1996 年首次描述后部可逆性脑病综合征（PRES）以来，已经过去了二十多年。由于成像方式的改进和更易于获得，它的认识度不断提高。目前，其确切的病理生理机制尚未完全了解，仍存在争议。准确的诊断对于指导及时、恰当的治疗至关重要。随着我们在过去 20 年中对该疾病谱的了解不断增加，我们区分它与其他急性神经障碍的能力可能会提高。我们强调了认识其诊断标准和生物标志物的重要性，这对于评估结果或研究设计都具有重要意义。PRES 的预后通常较好，但也可能会出现神经后遗症甚至死亡，尤其是在可能导致严重发病率甚至死亡率的严重形式中，尤其是当该综合征伴有颅内出血或脑梗死时。在这篇综述中，描述了 PRES 的病理生理学、诊断方法、一些预后争议以及未来的研究方向。
