کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6009690 | 1579800 | 2017 | 4 صفحه PDF | دانلود رایگان |
- Clinical and radiological findings of PRES are heterogeneous with possible atypical presentations: in this regard an accurate differential diagnosis is mandatory in order to provide prompt intervention.
- Isolated pons involvement has been rarely described. A key feature may be poor clinical presentation in spite of a radiological pattern of severity.
- Severe hypertension acts as the more frequently reported predisposing factor for isolated pontine PRES
BackgroundPosterior Reversible Encephalopathy Syndrome (PRES) is a clinical-radiological syndrome, usually reversible and with a favorable prognosis, which recognizes a variety of etiologies and clinical patterns and is likely due to an impairment in cerebral blood flow autoregulation. It is typically characterized by subcortical, predominantly parieto-occipital, vasogenic brain oedema in patients with acute-subacute neurological symptoms. Infratentorial oedema on neuroimaging has been mostly described in association with the typical supratentorial pattern and seldom as isolated.Case reportWe report a case of PRES with isolated pons involvement on MRI. A woman affected by Turner syndrome, epilepsy, slight mental deficiency, obesity and hypothyroidism, experienced a progressive gait and standing impairment, worsening in the last 2Â weeks. At admission blood pressure was 220/110Â mmHg. Brain MRI showed a wide FLAIR signal hyperintensity on T2-weighted sequences affecting the entire pons, without contrast enhancement. Clonidine, doxazosine, furosemide and telmisartan were effective in restoring normal blood pressure. Pons hyperintensity completely resolved on MRI 3Â weeks later, together with return to normal neurological examination.ConclusionsThough isolated infratentorial involvement in PRES recognizes several causes, hypertension, which is a common feature in Turner syndrome, would have played a key role in our case with solely pons MRI T2-hyperintensity.
Journal: eNeurologicalSci - Volume 6, March 2017, Pages 51-54