Hypertensive brain stem encephalopathy

Liao, Pen Yuan; Lee, Chien‐Chang; Chen, Cheng-Yu

doi:10.1016/j.ajem.2014.06.032

Cited by 5 publications

(2 citation statements)

References 6 publications

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“…Only three patients with similar conditions were identified in the English-language literature ( Table 1). [11][12][13] Including our patient, this group was predominantly male and had onset during middle age, similar to other patient groups. 14 They manifested severe acceleration of hypertension, absence of prominent focal neurologic dysfunction, undergoing hemodialysis, and recovery from PRES, suggesting that severe acceleration of hypertension may be an important factor in the development of brainstem variant of PRES.…”

Section: Discussionsupporting

confidence: 75%

“…Brainstem variant of PRES has rarely been reported in ESRD patients on chronic dialysis. We searched PubMed from 1966 to December 2017 using MeSH terms: “hypertensive encephalopathy” or “posterior reversible encephalopathy syndrome” or “reversible posterior leukoencephalopathy syndrome”; “brainstem”; and “renal insufficiency, chronic” or “kidney failure, chronic” or “renal dialysis.” Only three patients with similar conditions were identified in the English‐language literature (Table ) . Including our patient, this group was predominantly male and had onset during middle age, similar to other patient groups .…”

Section: Discussionmentioning

confidence: 61%

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Atypical posterior reversible encephalopathy syndrome in a noncompliant hemodialysis patient: Case report and literature review

Chiang

Chen

et al. 2019

Hemodialysis International

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Posterior reversible encephalopathy syndrome (PRES) is a reversible vasogenic brain edema in patients who present with seizure, headache, visual disturbance, and altered mental status, and a characteristic neuroimaging profile. Although PRES predominantly affects the bilateral parieto‐occipital areas, involvement of the frontal and temporal lobes, basal ganglia, brainstem, and cerebellum is not uncommon. Isolated involvement of the brainstem and cerebellum sparing the parieto‐occipital lobe is rarely reported. Here, we describe a 47‐year‐old man with end‐stage renal disease on chronic hemodialysis who presented with prominent hypertension and coma after missing three dialysis sessions. On examination, there was paucity of focal neurologic signs. Diagnosis of PRES was based on brain magnetic resonance imaging findings that were consistent with vasogenic edema of the pons and cerebellum without involvement of other areas. With antihypertensive therapy and intense ultrafiltration during hemodialysis, the patient's blood pressure and consciousness returned to normal, along with complete resolution of the abnormal imaging findings. This case stresses that noncompliance with dialysis should be considered a risk factor for PRES. This case is considered relative to the available literature on three patients with brainstem variant of PRES.

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Section: Discussionsupporting

confidence: 75%

Section: Discussionmentioning

confidence: 61%