A case of post-operative posterior reversible encephalopathy syndrome in children: A preventable neurological catastrophe

Rastogi, Amit; Kaur, Jaspreet; Hyder, Rehman; Bhaskar, Bhanuprakash; Upadhyaya, Vijai D.; Singh, Anmol

doi:10.4103/ija.ija_437_19

Cited by 10 publications

(6 citation statements)

References 8 publications

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“…It was the treating clinician's knowledge that PRES can be associated with spinal anaesthesia that led to the consideration of PRES as the cause for this child's symptoms. There is one previous case report of PRES in a child post‐splenectomy [13]. In that case report, PRES was attributed to hypertension secondary to post‐operative pain rather than the splenectomy itself.…”

Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome in a child, following splenectomy under combined general and spinal anaesthesia

Gallop,

McNeillis

2023

Anaesthesia Reports

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SummaryPosterior reversible encephalopathy syndrome is a rare and serious condition that presents with acute neurological symptoms with characteristic changes on imaging. It can lead to substantial morbidity and mortality, but can be reversible if recognised and treated. Here, we report a case of posterior reversible encephalopathy syndrome in a child post‐splenectomy under general anaesthesia with spinal anaesthesia. As far as we are aware, this condition has not previously been described in relation to spinal anaesthesia in the paediatric population. This case demonstrates the importance of recognising blood pressure changes in children, which can be challenging due to age‐, sex‐ and height‐related centiles for blood pressure measurements. Posterior reversible encephalopathy syndrome should be considered as a differential diagnosis for headache in a patient that has had a spinal anaesthesia.

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Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome in a child, following splenectomy under combined general and spinal anaesthesia

Gallop,

McNeillis

2023

Anaesthesia Reports

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“…12 It is hypothesized that children have a narrower range of cerebral autoregulation and therefore the probability of having PRES is even higher than that in adults, in situations such as acute rise in blood pressure. 13,14 Prompt recognition and appropriate management potentially improves the diagnosis. 15 Our systematic review has shown that the proportion of patients with cortical signs, in particular visual signs, 16 which occurs in a third of adult PRES, is lower in children.…”

Section: Discussionmentioning

confidence: 99%

Etiology and clinical characteristics of pediatric non-neoplastic posterior reversible encephalopathy: systematic review

Jordão¹,

Raimundo²,

Jacinto³

et al. 2022

Porto Biomedical Journal

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Background: Although more commonly seen in adult population, posterior reversible encephalopathy syndrome (PRES) can also be observed in pediatric patients. The etiopathogenesis of pediatric PRES is poorly understood, and the available evidence comes mostly from childhood cancer. Analysis of the sociodemographic and clinical characteristics of the different noncancer-related types can improve the understanding of pediatric PRES.Methods: Systematic review of characteristics and outcome of noncancer pediatric PRES. Primary sources of investigation were identified and selected through Pubmed and Scopus databases. The research was complemented by reference search in relevant publications. Study protocol was registered (Prospero CRD42020165798).Results: We identified 449 cases of noncancer pediatric PRES from 272 studies, median age 10 (newborn to 17 years), 49.9% girls. The 4 most common groups of conditions were renal 165 (36.7%), hematologic 84 (18.7%), autoimmune 64 (14.3%), and cardiovascular 28 (6.2%) disorders. The 4 most prevalent precipitants identified were hypertensive crisis 119 (26.5%), corticosteroids 56 (12.5%), immunosuppression drugs 44 (9.8%), and biologic drugs 14 (3.1%). Clinical presentations included seizures 100 (22.3%), headaches 22 (4.9%), encephalopathy 17 (3.8%), visual disturbances 6 (1.3%), and focal deficit 3 (0.7%). The distribution of lesions was (n = 380): combined anterior/posterior circulation (40.8%), isolated posterior circulation (24.1%), anterior circulation (6.2%), and deep structures (1.6%). Residual neurological deficits occurred in about 1 out 10 cases.Conclusion: Pediatric PRES differs from the adult in etiology, precipitants, and clinical manifestations. Renal diseases predominate, acute raised blood pressure is less frequent, and cortical deficits are rarer. In addition, the proportion of patients with combined anterior/posterior circulation was higher. Permanent neurological sequels can occur.

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“…[4] Irrespective of the mechanism of its development, there is vasogenic edema within the occipital and parietal regions (approximately 95% of cases), related to the posterior cerebral arterial supply and with the edema usually being symmetrical. Rastogi et al [7] described a case of PRES developing in the postoperative period in a child who had splenectomy for hypersplenism, secondary to thalassemia major.…”

Section: Discussionmentioning

confidence: 99%

Postoperative posterior reversible encephalopathy syndrome in a hereditary spherocytosis child undergoing splenectomy

et al. 2022

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A case of post-operative posterior reversible encephalopathy syndrome in children: A preventable neurological catastrophe

Cited by 10 publications

References 8 publications

Posterior reversible encephalopathy syndrome in a child, following splenectomy under combined general and spinal anaesthesia

Posterior reversible encephalopathy syndrome in a child, following splenectomy under combined general and spinal anaesthesia

Etiology and clinical characteristics of pediatric non-neoplastic posterior reversible encephalopathy: systematic review

Postoperative posterior reversible encephalopathy syndrome in a hereditary spherocytosis child undergoing splenectomy

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