MRI Features of Posterior Reversible Encephalopathy Syndrome in 33 Patients
- 22 December 2009
- journal article
- Published by Wiley in Journal of Neuroimaging
- Vol. 20 (1), 22-28
- https://doi.org/10.1111/j.1552-6569.2008.00306.x
Abstract
BACKGROUND AND PURPOSE We report the clinical and radiological features of posterior reversible encephalopathy and compare our findings to the literature. METHODS The brain magnetic resonance imaging and clinical records of 33 patients were retrospectively evaluated. Twenty-four patients had follow-up imaging, which confirmed the reversibility of the lesions; 9 patients were clinically followed and recovered. The clinical records were analyzed for the age, sex, gender, underlying etiology, and clinical symptoms. MR images were evaluated for the distribution of the lesions, contrast enhancement and diffusion-weighted-imaging (DWI) features, reversibility, and complications. RESULTS The most commonly involved localizations were frontal lobe in 51.5%, parietal lobe in 84.8%, occipital lobe in 72.7%, temporal lobe in 33.3%, and cerebellum in 33.3%. Nineteen patients had DWI, which showed vasogenic edema in 17 and cytotoxic edema in 2. Sixteen patients had contrast-enhanced images; 4 of them showed focal enhancement. Nine patients had the complication of hemorrhage. CONCLUSION The involvement of different localizations formerly known as atypical is now commonly encountered. Intravenous contrast administration may be of use to demonstrate focal enhancement and exclude other diseases in the differential. DWI is essential to distinguish the type of edema. Repeat imaging including DWI should be performed to follow the response to therapy. J Neuroimaging 2010;20:22-28.Keywords
This publication has 22 references indexed in Scilit:
- Posterior Reversible Encephalopathy Syndrome: Incidence of Atypical Regions of Involvement and Imaging FindingsAmerican Journal of Roentgenology, 2007
- Distinct Imaging Patterns and Lesion Distribution in Posterior Reversible Encephalopathy SyndromeAmerican Journal Of Neuroradiology, 2007
- Posterior reversible encephalopathy syndrome: another manifestation of CNS SLE?Lupus, 2007
- "Recurrent" Posterior Reversible Encephalopathy SyndromeJournal of Computer Assisted Tomography, 2007
- PRES: posterior or potentially reversible encephalopathy syndrome?Neurological Sciences, 2006
- Implications of post-gadolinium MRI results in 13 cases with posterior reversible encephalopathy syndromeEuropean Journal of Radiology, 2005
- Neuroimaging in Posterior Reversible Encephalopathy SyndromeJournal of Neuroimaging, 2004
- Neuroimaging in Posterior Reversible Encephalopathy SyndromeJournal of Neuroimaging, 2004
- A Reversible Posterior Leukoencephalopathy SyndromeNew England Journal of Medicine, 1996
- Evidence that disruption of the blood-brain barrier precedes reduction in cerebral blood flow in hypertensive encephalopathy.Hypertension, 1984