The effect of presymptomatic hypertension in posterior reversible encephalopathy syndrome

Lee, Moon Kyu; Cho, Yang-Je; Lee, Seung-Koo; Jung, Seung Mun; Heo, Kyoung

doi:10.1002/brb3.1061

Cited by 7 publications

(5 citation statements)

References 13 publications

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“…The effect of PSH on PRES severity was studied in 65 patients with PRES by Lee et al [22]. The brain lesion distribution degree, or lesion scoring point (LSP) on MRI was numerically calculated and compared with presymptomatic blood pressure.…”

Section: Pathophysiology Of Pres In Children With Malignancy or Bone Marrow Failurementioning

confidence: 99%

Prognostic factors and seizure outcome in posterior reversible encephalopathy syndrome (PRES) in children with hematological malignancies and bone marrow failure: A retrospective monocentric study

Danhofer

Tomečková

Cerna

et al. 2019

Seizure

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The aim of this study was to evaluate seizure outcome in children with hematological malignancies and PRES and to identify prognostic factors that could help manage the syndrome. Method: We retrospectively reviewed the report data of 21 patients diagnosed with hematological malignancy or aplastic anemia and PRES between 2008 and 2018. Basic demographic data, oncology treatment, presymptomatic hypertension before PRES manifestation, neurological status, seizure type, and EEG and MRI findings at PRES onset and at the one-year follow-up visit were studied. Patients who developed remote symptomatic seizures or epilepsy were identified. Results: We included 21 children (11 females and 10 males) in the study. Sixteen patients (76.2%) were diagnosed with ALL and the rest individually with AML, CML, T-lymphoma, Burkitt lymphoma, and severe aplastic anemia. Presymptomatic hypertension (PSH) was evaluated in 19 patients and was present in 18 (94.7%). The duration was 9 h and more in 16 patients (88.8%); the severity was grade II in 12 patients (66.7%). Seizures as the initial symptom of PRES were present in 17 patients (80.9%). Four patients (19.0%) were assessed with remote symptomatic seizures. Two of them (9.5%) had ongoing seizures at the one-year follow-up visit and were diagnosed with epilepsy. The presence of gliosis on follow-up MRI indicated worse outcome with development of epilepsy (without statistical significance). Conclusions: PRES syndrome has an overall good prognosis and the evolution to epilepsy is rare. The severity and duration of PSH or seizure severity and EEG findings at PRES onsetwere not associated with worse neurological outcomes in this study.

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Section: Pathophysiology Of Pres In Children With Malignancy or Bone Marrow Failurementioning

confidence: 99%

Prognostic factors and seizure outcome in posterior reversible encephalopathy syndrome (PRES) in children with hematological malignancies and bone marrow failure: A retrospective monocentric study

Danhofer

Tomečková

Cerna

et al. 2019

Seizure

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“…MRI findings characteristically demonstrate increased signal on T2 and FLAIR with vasogenic edema in the parieto-occipital and posterior temporal lobes, however, imaging abnormalities are not strictly confined to the posterior parieto-occipital and temporal lobes but can be seen diffusely involving the frontal lobes, basal ganglia and cerebellum [1]. One study found that patients with higher BP in presymptomatic period of PRES tended to have a larger vasogenic edematous lesions [9]. Another study published in the Mayo clinic proceedings found that the severity of edema on brain MRI did not correlate clinically with the degree of hypertension or severity of the clinical presentation [4].…”

Section: Imagingmentioning

confidence: 99%

Cocaine-Induced Posterior Reversible Encephalopathy Syndrome (PRES): A Case Report and Review of the Literature

Dasari¹,

Donohoe²

2018

J Neuroimaging Psychiatry Neurol

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Background: Posterior Reversible Encephalopathy Syndrome (PRES) is a clinical-radiological phenomenon that occurs due to a disruption in the autoregulation of the cerebral blood flow resulting in vasogenic edema. It is seen most often in settings of acute hypertension and is often associated with eclampsia. Symptoms that PRES patients commonly present with include seizures, visual disturbances, headache, and altered mental status. Case: We present a patient and review select cases cited in the literature that cocaine, a common drug of abuse, can precipitate hypertension with PRES. Our patient initially presented with severe headache, acute renal failure, hypertension, profound somnolence, and a widespread vasogenic edema after relapsing and using cocaine. Within 24 hours and with control of her blood pressure, her symptoms resolved and she was alert, cognitively intact and free from any identifiable residual effects. Conclusion: We suggest that this rapid sequence of clinical and neuroimaging abnormalities following cocaine ingestion may not be a rare phenomenon. As has been previously described, the magnitude of PRES related vasogenic edema is not well correlated with either symptom severity or ultimate clinical outcome.

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“…[ 8 ] Patients who had relatively well-controlled hypertension in the immediate presymptomatic period were reported to have less extensive lesions by MRI. [ 11 ]…”

Section: Discussionmentioning

confidence: 99%

Posterior reversible encephalopathy syndrome in a pediatric heart transplant recipient with coarctation of aorta

Das¹,

Ghaleb²,

Moskowitz³

et al. 2022

Annals of Pediatric Cardiology

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Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiographic syndrome reported in children with hypertension due to renal diseases, immunosuppression after solid organ transplant, cytotoxic agents for chemotherapy, and many others rare instances. We described PRES in a 6-year-old child with hypertension secondary to an incidental postoperative coarctation of the aorta after heart transplantation (HT). Her blood pressure was well controlled with amlodipine during the outpatient visits and home monitoring of blood pressure, but she had hypertension when presented with neurological symptoms. This case’s unique feature is that although PRES has been described after pediatric HT, this is the first case report due to a postoperative coarctation of the proximal descending aorta related to scarring from previous multiple sternotomies leading to inadvertent external compression of the aorta with scar tissue. We discussed the risk factors associated with hypertension before PRES and the correlation of brain magnetic resonance imaging findings with clinical outcomes.

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The effect of presymptomatic hypertension in posterior reversible encephalopathy syndrome

Cited by 7 publications

References 13 publications

Prognostic factors and seizure outcome in posterior reversible encephalopathy syndrome (PRES) in children with hematological malignancies and bone marrow failure: A retrospective monocentric study

Prognostic factors and seizure outcome in posterior reversible encephalopathy syndrome (PRES) in children with hematological malignancies and bone marrow failure: A retrospective monocentric study

Cocaine-Induced Posterior Reversible Encephalopathy Syndrome (PRES): A Case Report and Review of the Literature

Posterior reversible encephalopathy syndrome in a pediatric heart transplant recipient with coarctation of aorta

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