Postoperative Reversible Posterior Leukoencephalopathy Syndrome

Triquenot-Bagan, Aude; Gérardin, Emmanuel; Guégan-Massardier, Évelyne; Y, Onnient; Leroy, Fannie; Mihout, B

doi:10.1159/000072568

Cited by 7 publications

(5 citation statements)

References 9 publications

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“…Triquenot-Bagan et al reported the occurrence of RPLS after abdominal aortic surgery but this patient had also experienced a crisis of severe arterial hypertension [13].…”

Section: Discussionmentioning

confidence: 89%

Reversible Posterior Leukoencephalopathy Syndrome Following Surgery

Höll

Kapeller²,

Feichtinger³

et al. 2008

Clin Neuroradiol

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“…Triquenot-Bagan et al reported the occurrence of RPLS after abdominal aortic surgery but this patient had also experienced a crisis of severe arterial hypertension [13].…”

Section: Discussionmentioning

confidence: 89%

Reversible Posterior Leukoencephalopathy Syndrome Following Surgery

Höll

Kapeller²,

Feichtinger³

et al. 2008

Clin Neuroradiol

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“…The rapid increase in BP in our patient in the postoperative period might have contributed to this syndrome. Though isolated reports of PRES following surgery are available in literature, it has mostly been in the background of disorders otherwise known to manifest with hypertension [7,8]. None have presented following spine surgery.…”

Section: Discussionmentioning

confidence: 99%

Posterior Reversible Encephalopathy Syndrome in a Case of Postoperative Spinal Extradural Haematoma: Case Report and Review of Literature

2011

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A 14-year-old girl presented with progressive paraparesis and paresthesia of one-year duration. Magnetic resonance imaging revealed a T6 vertebral hemangioma with epidural compression on the spinal cord. Following angiography and embolization, she underwent dorsal laminectomy and excision of the soft tissue component compressing the cord. In the postoperative period she had rapid worsening of lower limb power and imaging demonstrated an epidural haematoma at the operative site. The patient was taken up for urgent re-exploration and evacuation of haematoma. Postoperatively the patient complained of visual failure, headache and had multiple episodes of seizures. An magnetic resonance imaging brain showed characteristic features of posterior reversible encephalopathy syndrome (PRES) and the patient improved gradually after control of hypertension. This is the first documented case of PRES following spinal cord compression in a patient without any known risk factors. We postulate the possible mechanism involved in its pathogenesis.

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“…To date, four cases of PRES have been reported in an immediate post-operative period [2,3,7,8]. All the reported cases of post-operative PRES occurred in the context of severe hypertension, where blood pressure was elevated beyond 180/110 mmHg.…”

Section: Discussionmentioning

confidence: 99%

“…In the fourth report, Triquenot-Bagan et al reported the case of a 55-year-old man who was operated on for an abdominal aortic aneurysm and developed a severe diffuse headache with vomiting eight days after the surgical intervention. A neurological examination was positive for cortical blindness, and his blood pressure was 180/110 mmHg [7]. It is worthy of note that one of the four reported cases of PRES was initially misdiagnosed as bilateral posterior cerebral artery infarctions [3].…”

Section: Discussionmentioning

confidence: 99%

Posterior leukoencephalopathy following repair of an ileocecal anastomosis breakdown: a case report and review of the literature

et al. 2011

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IntroductionPosterior reversible leukoencephalopathy syndrome refers to a constellation of neurologic symptoms related to temporary white matter changes. The disease typically presents in the context of an abrupt and drastic elevation in blood pressure (>180/110 mmHg). We report an unusual case of posterior reversible leukoencephalopathy syndrome in a post-operative setting, with a blood pressure parameter generally tolerated by most patients.Case presentationWe report the case of a 22-year-old Caucasian man who suffered acute onset visual acuity loss four days after an ileocecal anastomosis. A head magnetic resonance imaging scan revealed findings typically associated with posterior reversible leukoencephalopathy syndrome. His symptoms developed in the context of blood pressure parameters that are typically well tolerated in a post-operative setting (150-160/80-90 mmHg). He did not have a history of renal failure or immunosuppression. His symptoms resolved with aggressive blood pressure management.ConclusionsPosterior reversible leukoencephalopathy syndrome can occur in a post-operative setting with blood pressure parameters typically well-tolerated in most post-surgical patients. Timely diagnosis and treatment will minimize the risk of permanent neurologic injury.

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Postoperative Reversible Posterior Leukoencephalopathy Syndrome

Cited by 7 publications

References 9 publications

Reversible Posterior Leukoencephalopathy Syndrome Following Surgery

Reversible Posterior Leukoencephalopathy Syndrome Following Surgery

Posterior Reversible Encephalopathy Syndrome in a Case of Postoperative Spinal Extradural Haematoma: Case Report and Review of Literature

Posterior leukoencephalopathy following repair of an ileocecal anastomosis breakdown: a case report and review of the literature

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