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Rare Case of Posterior Reversible Leukoencephalopathy Syndrome Secondary to Acute Chest Syndrome

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ABSTRACT

We present a case of 29/m with a history of sickle cell disease who presented to the emergency department with sudden onset of chest, trunk, extremity, and back pain, consistent in quality and severity with the patient's usual pain crises. Soon after admission to the medical unit for acute chest syndrome (ACS), the patient developed sudden onset of hypertension associated with left sided hemiplegia, lethargy, dysarthria, aphasia, and left sided facial droop. Neuroimaging revealed that on MRI Brain there was multifocal extensive signal abnormality and a small focal areas of hemorrhage compatible with posterior reversible leukoencephalopathy syndrome (PRES). Patient was treated with levetiracetam and phenytoin and improved soon afterwards, with resolution seen on follow-up MRI two months later.

No MeSH data available.


Related in: MedlinePlus

MRI Brain-Axial FLAIR-weighted images demonstrate improvement in the areas of edema over 10 days and 2 months.
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fig4: MRI Brain-Axial FLAIR-weighted images demonstrate improvement in the areas of edema over 10 days and 2 months.

Mentions: Follow-up MRI Brain was done 10 days later, which showed partial resolution of the abnormal signal within the periventricular white matter, subcortical white matter, basal ganglia, and brainstem (Figures 4(a) and 4(b)). A further follow-up MRI was done 2 months later, which showed near complete resolution of hemorrhage and white matter abnormalities, as well as a completely normal neurological exam (Figures 4(a) and 4(b)).


Rare Case of Posterior Reversible Leukoencephalopathy Syndrome Secondary to Acute Chest Syndrome
MRI Brain-Axial FLAIR-weighted images demonstrate improvement in the areas of edema over 10 days and 2 months.
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC5121436&req=5

fig4: MRI Brain-Axial FLAIR-weighted images demonstrate improvement in the areas of edema over 10 days and 2 months.
Mentions: Follow-up MRI Brain was done 10 days later, which showed partial resolution of the abnormal signal within the periventricular white matter, subcortical white matter, basal ganglia, and brainstem (Figures 4(a) and 4(b)). A further follow-up MRI was done 2 months later, which showed near complete resolution of hemorrhage and white matter abnormalities, as well as a completely normal neurological exam (Figures 4(a) and 4(b)).

View Article: PubMed Central - PubMed

ABSTRACT

We present a case of 29/m with a history of sickle cell disease who presented to the emergency department with sudden onset of chest, trunk, extremity, and back pain, consistent in quality and severity with the patient's usual pain crises. Soon after admission to the medical unit for acute chest syndrome (ACS), the patient developed sudden onset of hypertension associated with left sided hemiplegia, lethargy, dysarthria, aphasia, and left sided facial droop. Neuroimaging revealed that on MRI Brain there was multifocal extensive signal abnormality and a small focal areas of hemorrhage compatible with posterior reversible leukoencephalopathy syndrome (PRES). Patient was treated with levetiracetam and phenytoin and improved soon afterwards, with resolution seen on follow-up MRI two months later.

No MeSH data available.


Related in: MedlinePlus