Abstract
Introduction
Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome with acute heterogeneous neurological symptoms. It is usually preceded by hypertension or chemotherapy. Brain magnetic resonance imaging (MRI) shows vasogenic edema over the cortex and subcortex of parieto-occipital lobes. Involvement of the brainstem, basal ganglia, and spinal cord is rare.
Material
Here we described an 18 years old woman with a history of systemic lupus erythematosus who was admitted due seizure and impaired consciousness. She had a mean arterial pressure of 160 and previously received cyclophosphamide.
Results
She had a unique involvement of diffuse bilateral asymmetric brain edema over the upper cervical cord, brainstem, cerebellum, thalami, basal ganglia, frontotemporal, and parieto-occipital lobes. She was diagnosed with PRES and after the treatment vasogenic edema vanished completely.
Conclusion
When it is clinically applicable, physicians should consider PRES as the differential diagnosis of vasogenic edema over the upper cervical cord, cerebellum, and brainstem.
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The authors included all data generated or analyzed during this study in this published article.
References
Tetsuka S, Ogawa T (2019) Posterior reversible encephalopathy syndrome: A review with emphasis on neuroimaging characteristics. J Neurol Sci 404:72–79. https://doi.org/10.1016/j.jns.2019.07.018
Triplett JD, Kutlubaev MA, Kermode AG, Hardy T (2022) Posterior reversible encephalopathy syndrome (PRES): diagnosis and management. Pract Neurol. practneurol-2021–003194. https://doi.org/10.1136/practneurol-2021-003194
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All authors contributed to the study's conception and design. Bardiya Ghaderi Yazdi studied the case, collected the data, and compiled the manuscript. Dr. Seyed Jalaleddin Hadei drafted and revised the manuscript for intellectual content. Dr. Nazila Malekian drafted, reviewed, and revised the manuscript for academic content. All authors commented on previous versions of the manuscript. The manuscript complies with all instructions to authors, authorship requirements have been met, and all authors approved the final manuscript.
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We acquired written informed consent to participate and publish from the patient. The Shariati hospital neurology department's ethics committee approved this study. Our study conforms to the requirements of the Declaration of Helsinki (1989).
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The authors have no relevant financial or non-financial interests to disclose.
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Ghaderi Yazdi, B., Hadei, S.J. & Malekian, N. Brainstem and upper cervical cord involvement in a patient with posterior reversible encephalopathy syndrome: Neuro-images. Neurol Sci 44, 2217–2219 (2023). https://doi.org/10.1007/s10072-023-06708-w
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DOI: https://doi.org/10.1007/s10072-023-06708-w