a Department of Neurology, Tongji Hospital, Tongji Medical College , Huazhong University of Science and Technology , Wuhan , China.
Int J Neurosci. 2019 Aug;129(8):808-813. doi: 10.1080/00207454.2018.1561452. Epub 2019 Feb 17.
Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome, reversible vasogenic edema predominantly within parieto-occipital regions. However, isolated brainstem involvement in PRES has been rarely reported, little is known about its clinical manifestations, radiological features and outcomes. We reported a case with PRES with only brainstem involvement and performed a systematic review of published cases. Twenty-four cases, together with our case, were included in the analysis. Mean age was 43 years and 63% were males. Hypertension (50%), nephropathy (25%) and chemotherapy (21%) were the major risk factors. All patients except two had acute hypertension and 50% of patients had renal dysfunction at onset. The most common symptoms were altered consciousness (46%) and headache (46%), Seizure was only presented in 21% of patients. All patients except two were treated with antihypertension. Most patients recovered to their neurological baseline. Clinicians should recognize this unique variant finding in PRES. which always affects males with severe hypertension, especially combined with renal dysfunction. Antihypertensive treatment is the most widely used therapy. Outcome is usually well.
后部可逆性脑病综合征（PRES）是一种临床-影像学综合征，主要为顶枕叶区域的血管源性水肿可逆。然而，PRES 中孤立性脑干受累的情况很少见，其临床表现、影像学特征和结局知之甚少。我们报告了一例仅累及脑干的 PRES 病例，并对已发表的病例进行了系统回顾。共纳入 24 例病例（包括我们的病例）进行分析。平均年龄为 43 岁，男性占 63%。高血压（50%）、肾病（25%）和化疗（21%）是主要的危险因素。除 2 例外所有患者均有急性高血压，50%的患者在发病时有肾功能不全。最常见的症状是意识改变（46%）和头痛（46%），仅 21%的患者出现癫痫。除 2 例外所有患者均接受了降压治疗。大多数患者恢复到神经基线水平。临床医生应认识到 PRES 中这种独特的变异表现，其通常影响严重高血压的男性，尤其是合并肾功能不全的患者。降压治疗是最广泛使用的治疗方法。预后通常良好。
