Posterior reversible encephalopathy syndrome (PRES) with acute intracerebral hemorrhage
Presentation
Headache, confusion, seizures and visual loss.
Patient Data
Bilateral white matter hypodensities at posterior parietal lobes and left frontal lobe, suggestive of posterior reversible encephalopathy syndrome (PRES).
Right high parietal lobe white matter hyperdense area with mild perifocal edema, in keeping with acute intracerebral hemorrhage.
Case Discussion
Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state that occurs secondary to the inability of posterior circulation to auto-regulate in response to acute changes in blood pressure. Hyperperfusion with resultant disruption of the blood brain barrier results in vasogenic edema, but no infarction, most commonly in the parieto-occipital regions.