Maruyama Hajime, Fujikawa Hirohisa, Takimiya Ryuichi, Sato Hiroki
Department of Internal Medicine, Suwa Central Hospital, Nagano, JPN.
Department of Internal Medicine, Fujimi-Kogen Hospital, Nagano, JPN.
Cureus. 2023 Feb 10;15(2):e34843. doi: 10.7759/cureus.34843. eCollection 2023 Feb.
Posterior reversible encephalopathy syndrome (PRES) and cerebral infarction are both caused by hypertension, but they rarely occur together. If they do coexist, the selection of a management strategy is difficult because of their pathologic differences. Here, we present an uncommon case of brainstem and cerebellar PRES combined with acute lacunar infarction. For this patient, we used an aggressive blood pressure-lowering regimen during the acute phase of his condition. Once the cerebral edema caused by PRES began to improve, antiplatelet therapy was initiated. The treatment was ultimately successful, and the patient was discharged home. A return to work is now planned. Given the rarity of this combination of conditions and a lack of published evidence for management, our report will contribute to the literature concerning the treatment for this combination of conditions.
后部可逆性脑病综合征（PRES）和脑梗死均由高血压引起，但它们很少同时发生。如果二者并存，由于其病理差异，选择治疗策略会很困难。在此，我们报告一例罕见的脑干和小脑PRES合并急性腔隙性脑梗死的病例。对于该患者，我们在其病情急性期采用了积极的降压方案。一旦由PRES引起的脑水肿开始改善，即启动抗血小板治疗。治疗最终成功，患者出院回家。目前计划让其重返工作岗位。鉴于这种病症组合的罕见性以及缺乏已发表的治疗证据，我们的报告将为有关这种病症组合治疗的文献做出贡献。
