A case report on posterior reversible encephalopathy syndrome (PRES) in an elderly female

Abstract

Introduction and importance: Posterior Reversible Encephalopathy Syndrome (PRES) is a medical condition characterized by symptoms such as headache, altered consciousness, visual abnormalities, seizures, and associated radiological vasogenic edema. The condition, as its name suggests, is generally reversible. PRES typically affects individuals around the age of 45 and is rarely seen in the elderly population. Case presentation: In this report, we present the case of an 83-year-old woman who presented to the emergency department with a history of seizures and visual disturbances. Upon examination, her Glasgow Coma Scale (GCS) was 14, and she had a bilateral round, reactive regular pupils. A plain CT head was performed, which revealed multiple hemorrhagic areas in the occipital region associated with vasogenic edema. MRI was done which was suggestive of Posterior Reversible Encephalopathy Syndrome (PRES). The individual underwent conservative management in our institute and gradually recovered. Clinical Discussion: Posterior Reversible Encephalopathy Syndrome (PRES) typically presents in middle-aged individuals, with infrequent occurrences in the elderly population. Early radiological and clinical assessments are crucial for the prompt diagnosis of this condition. Additionally, it is essential to identify predisposing factors such as hypertension, eclampsia, electrolyte imbalances, renal failure, autoimmune diseases, and the use of cytotoxic drugs for optimum management of the patient. Conclusion: Posterior reversible encephalopathy syndrome (PRES) is generally reversible, as its name implies. Maintaining a high level of suspicion based on radiological and clinical correlations, coupled with the effective management of underlying conditions, can contribute to its potential reversibility.