Posterior reversible encephalopathy syndrome in intensive care medicine

Servillo, Giuseppe; Bifulco, Francesca; Robertis, Edoardo De; Piazza, Ornella; Striano, Pasquale; Tortora, Fabio; Striano, Salvatore; Tufano, R

doi:10.1007/s00134-006-0459-0

Cited by 178 publications

(194 citation statements)

References 36 publications

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“…It is well recognized to be accompanied by hypertensive encephalopathy, but the syndrome is indeed caused by numerous clinical conditions [3]. In our case, PRES was thought to be induced by uremia, because the patient did not exhibit hypertension and because hemodiafiltration therapy recovered the clinical and radiological findings.…”

Section: Discussionmentioning

confidence: 65%

“…In our case, PRES was thought to be induced by uremia, because the patient did not exhibit hypertension and because hemodiafiltration therapy recovered the clinical and radiological findings. Although precise mechanisms remain undetermined, uremic toxin-induced endothelial dysfunction is likely to play an important role in the development and the progression of the disease [3]. For example, multiple cytokines, such as interleukin-1b and tumor necrosis factor-a, are elevated in end-stage kidney disease [11,12].…”

Section: Discussionmentioning

confidence: 99%

“…It is caused by a number of clinical conditions, such as severe hypertension, eclampsia, immunosuppressive therapy, postrenal transplantation, and nephrotic syndrome [3]. It is diagnosed by the presence of both clinical and radiographic findings, and the prompt diagnosis and appropriate therapies can result in a complete recovery within a few weeks.…”

Section: Introductionmentioning

confidence: 99%

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Posterior reversible encephalopathy syndrome in a uremic patient with autosomal recessive polycystic kidney disease

et al. 2015

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Posterior reversible encephalopathy syndrome (PRES) is characterized by headache, seizures, altered mental status, and visual disturbance. It is diagnosed by the presence of both clinical symptoms and radiographic findings on the parietal-occipital lobes. We here report a 61-year-old woman with non-compensative liver cirrhosis and chronic kidney disease, presenting with uremia-induced PRES. She expressed loss of consciousness and subsequent visual disturbance, during the progression of uremia. She was treated with hemodiafiltration therapy, and the symptoms of PRES fully improved. The case is of particular interest, in that the appearance of abnormal findings on magnetic resonance imaging was delayed more than 2 weeks, as compared to that of clinical symptoms.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Posterior reversible encephalopathy syndrome in a uremic patient with autosomal recessive polycystic kidney disease

et al. 2015

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“…This is best achieved in a critical care environment utilising a multidisciplinary approach. Treatment should be centred on careful fluid management and blood pressure control with intravenous antihypertensives such as labetalol, nicardipine, sodium nitroprusside or hydralizine [16]. Continuous invasive blood pressure monitoring is advised as isolated measurements of blood pressure may be misleading.…”

Section: Discussionmentioning

confidence: 99%

Influenza A‐induced rhabdomyolysis and acute kidney injury complicated by posterior reversible encephalopathy syndrome

Fearnley

Lines²,

Lewington

et al. 2011

Anaesthesia

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SummaryWe report a case of Influenza A‐induced rhabdomyolysis causing acute kidney injury in a young adult female who required invasive ventilation and renal replacement therapy. This case was further complicated by posterior reversible encephalopathy syndrome. Although this represents an extremely rare neurological complication of Influenza A infection, an appreciation of the condition and its management is important, given the high numbers of critically ill patients recently affected by H1N1 Influenza A in intensive care units in the UK.

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“…There have been few case reports of involvement of the brainstem in PRES 1011. The involvement of medulla oblongata and especially the cervical cord, however, is very rare 4.…”

Section: Discussionmentioning

confidence: 99%

Involvement of the cervical cord and medulla in posterior reversible encephalopathy syndrome

Choh

Jehangir

Rasheed

et al. 2011

Annals of Saudi Medicine

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The posterior reversible encephalopathy syndrome (PRES) is characterized by patchy cortical and subcortical lesions in the distribution of the posterior circulation. The lesions are classically reversible. This syndrome has multiple etiologies, most of which cause acute hypertension. We present a case of PRES with involvement of the medulla and cervical cord (apart from the typical parieto-occipital lesions)-an extremely rare imaging manifestation of PRES. It is important to recognize the imaging findings of PRES in spinal cord, and avoid misdiagnosis as myelitis by proper clinical correlation. Typically patients with myelitis have a profound neurodeficit, while patients with spinal manifestations of PRES are asymptomatic. Involvement of the cord in PRES has probably been an underrecognized entity as spinal imaging is not routinely performed in posterior reversible encephalopathy syndrome.

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Posterior reversible encephalopathy syndrome in intensive care medicine

Abstract: Intensivists and other physicians involved in the evaluation of patients with presumed PRES must be aware of the clinical spectrum of the associated conditions, the diagnostic modalities, and the correct treatment.

Cited by 178 publications

References 36 publications

Posterior reversible encephalopathy syndrome in a uremic patient with autosomal recessive polycystic kidney disease

Posterior reversible encephalopathy syndrome in a uremic patient with autosomal recessive polycystic kidney disease

Influenza A‐induced rhabdomyolysis and acute kidney injury complicated by posterior reversible encephalopathy syndrome

Involvement of the cervical cord and medulla in posterior reversible encephalopathy syndrome

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