Limits...
Posterior reversible encephalopathy syndrome in the emergency department: case series and literature review.

Thompson RJ, Sharp B, Pothof J, Hamedani A - West J Emerg Med (2015)

Bottom Line: Posterior Reversible Encephalopathy Syndrome (PRES) often has variable presentations and causes, with common radiographic features-namely posterior white matter changes on magnetic resonance (MRI).We report three cases of PRES, all of which presented to the emergency department of a single academic medical center over a short period of time, including a 53-year-old woman with only relative hypertension, a 69-year-old woman who ultimately died, and a 46-year-old woman who had a subsequent intraparenchymal hemorrhage.PRES is likely much more common than previously thought and is a diagnosis that should be considered in a wide variety of emergency department patient presentations.

View Article: PubMed Central - PubMed

Affiliation: University of Wisconsin, Department of Emergency Medicine, Madison, Wisconsin.

ABSTRACT

Introduction: Posterior Reversible Encephalopathy Syndrome (PRES) often has variable presentations and causes, with common radiographic features-namely posterior white matter changes on magnetic resonance (MRI). As MRI becomes a more frequently utilized imaging modality in the Emergency Department, PRES will become an entity that the Emergency Physician must be aware of and be able to diagnose.

Case report: We report three cases of PRES, all of which presented to the emergency department of a single academic medical center over a short period of time, including a 53-year-old woman with only relative hypertension, a 69-year-old woman who ultimately died, and a 46-year-old woman who had a subsequent intraparenchymal hemorrhage.

Conclusion: PRES is likely much more common than previously thought and is a diagnosis that should be considered in a wide variety of emergency department patient presentations.

Show MeSH

Related in: MedlinePlus

T2 weighted magnetic resonance imaging of Patient 1, showing hyperintensity within the occipital lobe.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
getmorefigures.php?uid=PMC4307725&req=5

f1-wjem-16-5: T2 weighted magnetic resonance imaging of Patient 1, showing hyperintensity within the occipital lobe.

Mentions: The next day, MRI/MRA (magnetic resonance angiogram) head and neck with and without contrast showed symmetric T2 signal intensity within the occipital lobes, without evidence of infarction or enhancement, most consistent with PRES (Figure 1). Repeat neurologic exam by neurology service revealed bilateral left lower quadrantanopsia. Patient’s inpatient stay included extensive evaluation for autoimmune diseases, including a celiac panel, antinuclear antibodies, erythrocyte sedimentation rate, C-reactive protein, and anti-SCL-70 antibodies. All of these laboratory tests were resulted as with normal hospital reference ranges. Patient declined a lumbar puncture for further laboratory examination of her cerebral spinal fluid.


Posterior reversible encephalopathy syndrome in the emergency department: case series and literature review.

Thompson RJ, Sharp B, Pothof J, Hamedani A - West J Emerg Med (2015)

T2 weighted magnetic resonance imaging of Patient 1, showing hyperintensity within the occipital lobe.
© Copyright Policy - open-access
Related In: Results  -  Collection

License 1 - License 2
Show All Figures
getmorefigures.php?uid=PMC4307725&req=5

f1-wjem-16-5: T2 weighted magnetic resonance imaging of Patient 1, showing hyperintensity within the occipital lobe.
Mentions: The next day, MRI/MRA (magnetic resonance angiogram) head and neck with and without contrast showed symmetric T2 signal intensity within the occipital lobes, without evidence of infarction or enhancement, most consistent with PRES (Figure 1). Repeat neurologic exam by neurology service revealed bilateral left lower quadrantanopsia. Patient’s inpatient stay included extensive evaluation for autoimmune diseases, including a celiac panel, antinuclear antibodies, erythrocyte sedimentation rate, C-reactive protein, and anti-SCL-70 antibodies. All of these laboratory tests were resulted as with normal hospital reference ranges. Patient declined a lumbar puncture for further laboratory examination of her cerebral spinal fluid.

Bottom Line: Posterior Reversible Encephalopathy Syndrome (PRES) often has variable presentations and causes, with common radiographic features-namely posterior white matter changes on magnetic resonance (MRI).We report three cases of PRES, all of which presented to the emergency department of a single academic medical center over a short period of time, including a 53-year-old woman with only relative hypertension, a 69-year-old woman who ultimately died, and a 46-year-old woman who had a subsequent intraparenchymal hemorrhage.PRES is likely much more common than previously thought and is a diagnosis that should be considered in a wide variety of emergency department patient presentations.

View Article: PubMed Central - PubMed

Affiliation: University of Wisconsin, Department of Emergency Medicine, Madison, Wisconsin.

ABSTRACT

Introduction: Posterior Reversible Encephalopathy Syndrome (PRES) often has variable presentations and causes, with common radiographic features-namely posterior white matter changes on magnetic resonance (MRI). As MRI becomes a more frequently utilized imaging modality in the Emergency Department, PRES will become an entity that the Emergency Physician must be aware of and be able to diagnose.

Case report: We report three cases of PRES, all of which presented to the emergency department of a single academic medical center over a short period of time, including a 53-year-old woman with only relative hypertension, a 69-year-old woman who ultimately died, and a 46-year-old woman who had a subsequent intraparenchymal hemorrhage.

Conclusion: PRES is likely much more common than previously thought and is a diagnosis that should be considered in a wide variety of emergency department patient presentations.

Show MeSH
Related in: MedlinePlus