Document Detail


Neuroimaging in posterior reversible encephalopathy syndrome.
MedLine Citation:
PMID:  15095552     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The terms posterior reversible leukoencephalopathy, reversible posterior cerebral edema syndrome, and posterior reversible encephalopathy syndrome (PRES) all refer to a clinicoradiologic entity characterized by headaches, confusion, visual disturbances, seizures, and posterior transient changes on neuroimaging. Clinical findings are not sufficiently specific to readily establish the diagnosis; in contrast, magnetic resonance imaging pattern is often characteristic and represents an essential component of the diagnosis of PRES. Typical lesions predominate in the posterior white matter, with some involvement of the overlying cortex; are hyperintense on T2-weighted images; and are usually hypointense or isointense on diffusion-weighted images, with an increase of the apparent diffusion coefficient, indicating vasogenic edema. The pathogenesis is incompletely understood, although it seems to be related to the breakthrough of autoregulation and endothelial dysfunction. Since its initial description, this syndrome has been subsequently described in an increasing number of medical conditions, including hypertensive encephalopathy, eclampsia, and the use of cytotoxic and immunosuppressive drugs. The diagnosis has important therapeutic and prognostic implications because the reversibility of the clinical and radiologic abnormalities is contingent on the prompt control of blood pressure and/or discontinuing the offending drug. On the contrary, when unrecognized, conversion to irreversible cytotoxic edema may occur.
Authors:
C Lamy; C Oppenheim; J F Méder; J L Mas
Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Journal of neuroimaging : official journal of the American Society of Neuroimaging     Volume:  14     ISSN:  1051-2284     ISO Abbreviation:  J Neuroimaging     Publication Date:  2004 Apr 
Date Detail:
Created Date:  2004-04-20     Completed Date:  2004-06-25     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  9102705     Medline TA:  J Neuroimaging     Country:  United States    
Other Details:
Languages:  eng     Pagination:  89-96     Citation Subset:  IM    
Affiliation:
Neurology Department, Hôpital Sainte-Anne, 1, rue Cabanis, 75674 Paris, France. lamy@chsa.broca.inserm.fr
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MeSH Terms
Descriptor/Qualifier:
Brain / pathology
Brain Damage, Chronic / diagnosis,  pathology
Brain Ischemia / diagnosis*,  pathology
Diagnosis, Differential
Female
Humans
Hypertensive Encephalopathy / diagnosis*,  pathology
Image Enhancement*
Image Processing, Computer-Assisted*
Magnetic Resonance Imaging*
Neurologic Examination
Pregnancy
Prognosis

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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