Moughal Saad, Ahmad Sana, Saleem Nayyar, Derham Chris
Department of Neuroradiology, Leeds Teaching Hospitals NHS Trust, Leeds.
Department of Medicine, Pinderfields General Hospital, Wakefield.
Surg Neurol Int. 2023 Mar 17;14:94. doi: 10.25259/SNI_963_2022. eCollection 2023.
Posterior reversible encephalopathy syndrome (PRES) can occur due to the detrimental effect of malignant hypertension on cerebral autoregulation. Most reported cases describe involvement of the supratentorial areas. Involvement of the posterior fossa structures in conjunction with supratentorial involvement has also been reported; however, PRES affecting the infratentorial structures without supratentorial involvement is a rare phenomenon. Clinical manifestations can involve severe headache, seizures, and reduced consciousness with treatment focused primarily on blood pressure control.
We report a case of PRES with isolated involvement of the infratentorial structures leading to obstructive hydrocephalus. The patient was managed with aggressive control of blood pressure and avoided ventriculostomy or posterior fossa decompression with a good outcome.
Medical management in the absence of neurological deficit can be associated with a good outcome.
