A case of posterior reversible encephalopathy syndrome that occurred after surgery

Abstract

The main symptoms of posterior reversible encephalopathy syndrome (PRES) are caused by brain edema triggered by the breakdown of the blood-brain barrier, which includes impaired consciousness, seizures, headache, and visual impairment. This is a case of PRES, which developed postoperatively. A 62-year-old woman underwent lung resection due to a metastatic pulmonary tumor. Moreover, there was no apparent abnormality except for pain-induced hypertension (184/114 mmHg) on the second postoperative day. Head MRI was performed on the same day due to sudden generalized convulsions and visual disturbance. A hypertension-induced PRES diagnosis was made because of predominant subcortical white matter high-signal areas in the bilateral frontal, parietal, and occipital lobes. She was then treated with an antihypertensive drug and anticonvulsant. She was discharged without sequelae. In this paper, we report on PRES and its differentiation from cerebral infarction, a complication after thoracic surgery, along with a review of the literature.