Benjamin Betsy, Tewoldemedhin Bereket, Rodas Aaron
Family Medicine, Lower Bucks Hospital, Bristol, USA.
Internal Medicine, Lower Bucks Hospital, Bristol, USA.
Cureus. 2023 Mar 28;15(3):e36824. doi: 10.7759/cureus.36824. eCollection 2023 Mar.
Posterior reversible encephalopathy syndrome (PRES) is a subacute syndrome that is diagnosed by neurologic symptoms and radiologic findings. PRES is predominantly caused by uncontrolled hypertension though it has been associated with illicit drug use, specifically cocaine use. We describe a case of a 68-year-old male who developed visual disturbances and gait abnormalities. Imaging was confirmed with head CT that showed hypoattenuation in the posterior aspects of the occipital lobes. The patient was managed with anti-hypertensive medication and blood pressure monitoring during his hospital course. Therefore, the patient's neurological symptoms resolved once the blood pressure was well-controlled. MRI of the brain was completed prior to discharge and confirmed resolution. Hypertension and cocaine use has been documented as causative agents of PRES. It is most likely due to the inability of the posterior circulation of the brain to auto-regulate with acute changes in blood pressure resulting in hypoperfusion and disruption of the blood-brain barrier with resultant vasogenic edema without infarction.
后部可逆性脑病综合征（PRES）是一种通过神经系统症状和影像学表现进行诊断的亚急性综合征。PRES主要由血压控制不佳引起，尽管它与非法药物使用有关，特别是可卡因使用。我们描述了一例68岁男性患者，他出现了视觉障碍和步态异常。头部CT检查证实枕叶后部出现低密度影。患者在住院期间接受了抗高血压药物治疗和血压监测。因此，一旦血压得到良好控制，患者的神经症状就会缓解。出院前完成了脑部MRI检查，证实症状已缓解。高血压和可卡因使用已被记录为PRES的致病因素。这很可能是由于大脑后循环无法随着血压的急性变化进行自我调节，导致灌注不足和血脑屏障破坏，进而产生血管源性水肿而无梗死。
