IMPORTANT: We currently have a number of bugs related to image cropping and are actively trying to resolve them. In the meantime, we have disabled cropping. Apologies for any inconvenience. Stay informed: radiopaedia.org/chat

Posterior reversible encephalopathy syndrome (PRES) with acute intracerebral hemorrhage

Case contributed by Amro Omar
Diagnosis probable

Presentation

Headache, confusion, seizures and visual loss.

Patient Data

Age: 45 years
Gender: Male

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. 

How to use cases

You can use Radiopaedia cases in a variety of ways to help you learn and teach.

Creating your own cases is easy.

Updating… Please wait.

 Unable to process the form. Check for errors and try again.

 Thank you for updating your details.