Clinical and imaging characteristics of posterior reversible encephalopathy syndrome / 临床神经病学杂志

ABSTRACT

Objective To investigate the clinical and imaging characteristics of posterior reversible encephalopathy syndrome (PRES).Methods The clinical and imaging data of 7 patients with PRES were analyzed retrospectively.Results Among the 7 cases with PRES, 3 cases were secondary to pregnancy induced hypertension syndrome, 3 cases secondary to renal failure, 1 case secondary to hypertension.The clinical characteristics were that 7 cases presented with headache and disturbance of vision, 6 with epilepsy, 4 with nausea and vomitting, 1 with hemiparesis, 1 with ataxia.Cranial CT examination in 6 cases revealed occipital low density lesions in 3, widely white matter edema in 2, multiple small hematomas in 1, and no lesion in 2. Brain MRI showed that the occipital lobe was involved in 7 cases, cerebellar in 3, brain stem in 2, fronto-parietal subcortical white matter in 2, caudate nucleus in 1, thalamus in 1. The lesion showed gyrus-like abnominal signals in lobes and patchy abnormal signals in the other areas. The lesion showed low or iso-signal in T1WI, high signal in T2WI and Flair. 2 cases enhancement scannings showed no enhancement effect in 1 and gyrus, patchy and ring-like enhancement in another. The lesions demonstrated mild high signals in 2, low signal in 1 and no abnormalmality in 1 on DWI among 4 cases.Conclusions The headache, disturbance of vision and epilepsy are the principal clinical symptom in PRES . The imaging features of PRES are symmetrical long T1 and T2 signals on the bilateral posterior white matters of cerebrum.