| Spectrum and Potential Pathogenesis of Reversible Posterior Leukoencephalopathy Syndrome. | |
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MedLine Citation:
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PMID: 21703874 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Controversy still exists over the etiology and pathophysiology of reversible posterior leukoencephalopathy syndrome (RPLS). This large single-center case series aims to describe the clinical and imaging features of RPLS in an attempt to deduce the etiology of the disorder and the mechanisms of brain injury. METHODS: A retrospective chart and imaging review was conducted on 59 cases of RPLS in 55 patients. RESULTS: Five RPLS imaging patterns were observed: posterior predominant (n = 40), anterior predominant (n = 7), diffuse lesion (n = 7), basal ganglia predominant (n = 3), and brainstem/cerebellum predominant patterns (n = 2). RPLS resulted in permanent neurologic deficits in 14 patients and death in 4 patients. Hypertension was seen in 57 (97%) cases, and mean arterial blood pressure exceeded 140 mm Hg in 30 (51%) cases. Follow-up magnetic resonance imaging scans revealed a significant worsening of vasogenic edema in 2 cases, both with persistent hypertension. Magnetic resonance imaging scans revealed areas of ischemia in 14 cases, all within or at areas closely adjacent to vasogenic edema. Diffuse vasculopathy was seen in 8 cases. There was a lack of correlation between the presence of vasculopathy and the degree of vasogenic edema (P = .62), but a correlation was suggested between ischemia and vasculopathy (P = .02). CONCLUSIONS: This study strongly suggests that hypertension-induced vasodilation rather than vasoconstriction-mediated hypoxia is likely the major mechanism responsible for the development of vasogenic edema, and that vasoconstriction may contribute to the development of ischemia in RPLS. |
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Authors:
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Yuebing Li; Devang Gor; Debra Walicki; Donna Jenny; David Jones; Peter Barbour; John Castaldo |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-22 |
Journal Detail:
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Title: Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association Volume: - ISSN: 1532-8511 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-27 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9111633 Medline TA: J Stroke Cerebrovasc Dis Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 National Stroke Association. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Division of Neurology, Department of Medicine, Lehigh Valley Health Network, Allentown, Pennsylvania. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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