The Relationship between Hypertension and the Lesion Distribution of Posterior Reversible Encephalopathy Syndrome

ABSTRACT

BACKGROUND: The relationship between hypertension and the lesion distribution of posterior reversible encephalopathy syndrome (PRES) is in debate. METHODS: Twenty patients with PRES which developed during chemotherapy or immunosuppression treatment for the control of underlying malignancy or auto-immune disorders were selected from the database. Data regarding brain images, clinical symptoms, co-morbid illnesses, and mean arterial pressure (MAP) at the pre-symptomatic period (one day before the symptom onset) and at the symptom onset were collected. Patients were divided into two groups according to the presence of pre-symptomatic hypertension. The lesion distribution degree was calculated by numerical method (involvement score [IS]) and compared with MAP. RESULTS: No significant differences of clinical symptoms were found between two groups. IS and onset period MAP were higher in the hypertensive group. Pre-symptomatic MAP correlated with onset period MAP and IS in total patients. No significant correlation was found between IS and onset period MAP. CONCLUSIONS: The PRES patient with hypertension in the pre-symptomatic period would show more spatially distributed brain lesions than the patient with stable blood pressure.