Adhikari Sonu, Shrestha Neeyal, Shrestha Dinuj, Raut Rupesh, Ray Prajeet, Bista Prakash, Bhattarai Ayam
Department of Neurosurgery, Patan Academy of Health Science, Lalitpur, Nepal.
Ann Med Surg (Lond). 2024 Jul 1;86(8):4935-4939. doi: 10.1097/MS9.0000000000002343. eCollection 2024 Aug.
Posterior reversible encephalopathy syndrome (PRES) is a medical condition characterized by symptoms such as headache, altered consciousness, visual abnormalities, seizures, and associated radiological vasogenic edema. The condition, as its name suggests, is generally reversible. PRES typically affects individuals around the age of 45 and is rarely seen in the elderly population.
In this report, the authors present the case of an 83-year-old woman who presented to the emergency department with a history of seizures and visual disturbances. Upon examination, her Glasgow Coma Scale (GCS) was 14, and she had bilateral round,reactive, regular pupils. A plain computed tomography (CT) head was performed, which revealed multiple hemorrhagic areas in the occipital region associated with vasogenic edema. magnetic resonance imaging was done which was suggestive of PRES. The individual underwent conservative management in the authors' institute and gradually recovered.
PRES typically presents in middle-aged individuals, with infrequent occurrences in the elderly population. Early radiological and clinical assessments are crucial for the prompt diagnosis of this condition. Additionally, it is essential to identify predisposing factors such as hypertension, eclampsia, electrolyte imbalances, renal failure, autoimmune diseases, and the use of cytotoxic drugs for optimum management of the patient.
PRES is generally reversible, as its name implies. Maintaining a high level of suspicion based on radiological and clinical correlations, coupled with the effective management of underlying conditions, can contribute to its potential reversibility.
后部可逆性脑病综合征(PRES)是一种医学病症,其特征为头痛、意识改变、视觉异常、癫痫发作以及相关的放射学血管源性水肿等症状。顾名思义,该病症通常是可逆的。PRES通常影响45岁左右的个体,在老年人群中很少见。
在本报告中,作者呈现了一名83岁女性的病例,该患者因癫痫发作和视觉障碍病史就诊于急诊科。经检查,她的格拉斯哥昏迷量表(GCS)评分为14分,双侧瞳孔圆形、对光反射灵敏且规则。进行了头颅平扫计算机断层扫描(CT),结果显示枕叶区域有多个出血灶并伴有血管源性水肿。磁共振成像检查提示为PRES。该患者在作者所在机构接受了保守治疗并逐渐康复。
PRES通常在中年个体中出现,在老年人群中较少见。早期的放射学和临床评估对于该病症的及时诊断至关重要。此外,识别诸如高血压、子痫、电解质失衡、肾衰竭、自身免疫性疾病以及使用细胞毒性药物等诱发因素对于患者的最佳治疗至关重要。
如名称所示,PRES通常是可逆的。基于放射学和临床相关性保持高度怀疑,并有效管理潜在疾病,有助于其潜在的可逆性。