Post-transfusion reversible posterior leukoencephalopathy syndrome with cerebral vasoconstriction

Ito, Yasuhiro; Niwa, Hideto; Iida, Takafumi; Nagamatsu, M.; Yasuda, Takeshi; Yanagi, Tsutomu; Sobue, Gen

doi:10.1212/wnl.49.4.1174

Cited by 108 publications

(76 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…High blood pressure was present in the majority of patients, supporting the hypothesis of cerebral autoregulation impairment as the main pathogenic mechanism in PRES 1,10 . When cerebral autoregulation capacity is overcome by systemic blood pressure, cerebral hyperperfusion emerges, damaging the blood brain barrier and originating liquid leakage to the extracellular space and vasogenic edema, mainly in arterial border territories 1,10,14,15,16 . The fact that only 4 patients had previous high blood pressure supports the idea that sudden elevation of blood pressure prevents vascular adaptation to take place.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndrome

Pereira

Pinho

Rodrigues

et al. 2015

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

Objective: Analyze the cases of posterior reversible encephalopathy syndrome (PRES) admitted in a Neurology Department during an 8-year period. Method: Retrospective observational study in a central hospital in the north of Portugal. Results: 14 patients were identified, mean age 52.3 years. Precipitating factors included: eclampsia, isolated arterial hypertension, spinal trauma and autonomic dysreflexia, Guillain-Barré syndrome, sepsis, sarcoidosis and pulmonary cryptococcosis and drugs. Most patients presented posterior-predominant vasogenic edema lesions, however 64.2% presented frontal lesions and in 42.8% cerebellum was involved. Four patients also had acute ischemic lesions and 1 had hemorrhagic lesions. During follow-up 10 patients recovered fully, 2 recovered partially, 1 suffered a recurrence and 2 died in hospital. Conclusion: PRES has many etiological factors. The terms posterior and reversible should be revised because PRES frequently involves other brain regions and it is not always reversible. PRES patients may develop life-threatening complications and mortality is not negligible.Keywords: posterior reversible encephalopathy syndrome, vasogenic edema, arterial hypertension. RESUMOObjetivo: Análise dos casos de síndrome de encefalopatia posterior reversível (PRES) internados em um Serviço de Neurologia durante oito anos. Método: Estudo restrospectivo observacional num hospital central do norte de Portugal. Resultados: Identificaram-se 14 casos, idade média de 52,3 anos. Os factores precipitantes foram: eclâmpsia, hipertensão arterial isolada, traumatismos vertebro-medulares com disfunção autonómica, síndrome de Guillain-Barré, sépsis, sarcoidose e criptococose pulmonar e fármacos. A maioria dos doentes apresentou lesões edematosas de predomínio posterior, contudo 64,2% apresentaram lesões frontais e 42,8% apresentaram também lesões cerebelosas. Quatro doentes tinham lesões isquémicas agudas e um apresentou lesões hemorrágicas. Durante o seguimento, 10 doentes recuperaram totalmente, 2 recuperaram com sequelas, 1 teve recidiva e 2 faleceram durante o internamento. Conclusão: A PRES apresenta muitos factores precipitantes. As designações posterior e reversível deverão ser reequacionadas dado que a PRES afecta outras zonas do cérebro e nem sempre é reversível, apresentado complicações e mortalidade não negligenciáveis.Palavras-chave: síndrome de encefalopatia posterior reversível, edema vasogénico, hipertensão arterial.

show abstract

Section: Discussionmentioning

confidence: 99%

“…It has been suggested that in PRES, arteriolar vasoconstriction occurs in response to cerebral hyperperfusion, thus leading to hypoperfusion, ischemia and subsequent edema 10,15,16 . Although angiographic studies demonstrate focal or diffuse vasoconstriction, ischemic complications are not frequent 20 .…”

Section: Discussionmentioning

confidence: 99%

Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndrome

Pereira

Pinho

Rodrigues

et al. 2015

Arq. Neuro-Psiquiatr.

View full text Add to dashboard Cite

show abstract

“…Many other associations have been reported, including microangiopathy [2], sickle cell disease [10], intravenous immunoglobulin use [28], large-volume red cell transfusion [16], stem cell re-infusion [12], use of erythropoietin or G-CSF [5,17], hypercalcemia [18], and acute intermittent porphyria [19,26].…”

Section: Discussionmentioning

confidence: 99%

“…Hypertension is also a feature in the vast majority of RPLS reported [5,7,[9][10][11][13][14][15][16]19,21,[23][24][25][26]. In contrast to encephalopathy caused by isolated malignant hypertension, patients with RPLS often present with only moderate levels of hypertension (systolic blood pressure 130-200 mmHg, diastolic blood pressure generally > 90 mmHg); in the majority of cases this still represents a significant increase above baseline levels.…”

Section: Discussionmentioning

confidence: 99%

“…Posterior hemispheric predilection may be explained by poor sympathetic innervation of vertebrobasilar system relative to the carotid system [6]. Evidence supporting vascular pathogenesis of RPLS includes demonstrations of vasospasm during acute-phase RPLS [11,16] and MR brain-water diffusion studies suggesting that white matter edema in RPLS is largely vasogenic in origin [21,23,25].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Reversible posterior leukoencephalopathy syndrome complicating cytotoxic chemotherapy for hematologic malignancies

et al. 2004

View full text Add to dashboard Cite

Reversible posterior leukoencephalopathy syndrome (RPLS) is an uncommon but distinctive clinicoradiological entity comprising of headache, seizures, visual disturbance, and altered mental function, in association with posterior cerebral white matter edema. With appropriate management, RPLS is reversible in the majority of cases. Previous reported associations of RPLS include hypertension, eclampsia, renal failure, and use of immunosuppressive drugs; reports in the adult hematology setting are rare. We report two cases of adults undergoing treatment for hematological malignancies who developed RPLS, and we emphasize the importance of early recognition and institution of appropriate management in reducing the risk of development of permanent neurological disability. Am.

show abstract

Postpartum Angiopathy With Reversible Posterior Leukoencephalopathy

Singhal¹

2004

Arch Neurol

242

202

View full text Add to dashboard Cite

show abstract

Post-transfusion reversible posterior leukoencephalopathy syndrome with cerebral vasoconstriction

Cited by 108 publications

References 3 publications

Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndrome

Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndrome

Reversible posterior leukoencephalopathy syndrome complicating cytotoxic chemotherapy for hematologic malignancies

Postpartum Angiopathy With Reversible Posterior Leukoencephalopathy

Contact Info

Product

Resources

About