Abstract
Posterior reversible encephalopathy syndrome (PRES) is a relatively new clinical entity characterized by reversible neurological symptoms with findings indicating leukoencephalopathy on imaging studies. Reports of PRES in the field of anesthesiology have been quite limited. A patient with therapeutic anticoagulant developed PRES immediately after emergence from anesthesia, in which her status was initially recognized as delayed recovery from anesthesia with transient hypertension because an emergent head computed tomography (CT) scan was almost normal. Subsequently, magnetic resonance imaging (MRI) was also performed according to a radiologist’s recommendation because the CT results showed areas of slightly low attenuation in the frontoparieto-occipital lobes bilaterally, suggesting PRES; otherwise, ischemic events. MRI showed subcortical increased T2 and fluid-attenuated inversion recovery (FLAIR) intensity in the occipitoparietal regions bilaterally with slight increase in the apparent diffusion coefficient signal on diffusion-weighted imaging, which confirmed a diagnosis of PRES. Gradually, the patient regained consciousness and became responsive with antihypertensive therapy. A prompt and accurate diagnosis of PRES is important to avoid irreversible brain damage, for example, intracranial hemorrhage, especially in a patient receiving anticoagulation therapy.
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This case report does not include any conflict of interest. This case report was supported only by departmental sources.
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Inoue, S., Kawaguchi, M. & Furuya, H. A case of posterior reversible encephalopathy syndrome after emergence from anesthesia. J Anesth 26, 111–114 (2012). https://doi.org/10.1007/s00540-011-1256-7
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DOI: https://doi.org/10.1007/s00540-011-1256-7