Understanding Posterior Reversible Encephalopathy Syndrome

  • S. Legriel
  • F. Pico
  • E. Azoulay
Chapter
Part of the Annual Update in Intensive Care and Emergency Medicine 2011 book series (AUICEM, volume 1)

Abstract

Posterior reversible encephalopathy syndrome (PRES) [1], [2] is a clinicoradiological entity that was well described by Hinchey et al. [3] in 1996 based on 15 cases, shortly after two other small case-series were published [4], [5]. This condition has been designated by a variety of names (reversible posterior leukoencephalopathy syndrome, reversible posterior cerebral edema syndrome, and reversible occipital parietal encephalopathy). PRES is now the accepted term [1], [2], [6] but has been challenged recently based on the risk of neurological impairment and up to 15 % mortality rate [7], [8]. PRES is characterized by variable associations of seizure activity, consciousness impairment, headaches, visual abnormalities, nausea/vomiting, and focal neurological signs. The cerebral imaging abnormalities are often symmetric and predominate in the posterior white matter (Fig. 1). Recognition of PRES has evolved with increasing availability of magnetic resonance imaging (MRI).
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Fig. 1

Cerebral magnetic resonance imaging in a patient with posterior reversible encephalopathy syndrome (PRES). Fluid-attenuated inversion recovery (FLAIR) sequence showing bilateral high-signal foci in the cerebellum, basal ganglia, and occipital, parietal, frontal, and temporal lobes

Keywords

Magnetic Resonance Angiography Status Epilepticus Progressive Multifocal Leukoencephalopathy Mean Arterial Blood Pressure Occipital Lobe 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.
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Copyright information

© Springer Science+Business Media LLC 2011

Authors and Affiliations

  • S. Legriel
    • 1
  • F. Pico
    • 2
  • E. Azoulay
    • 3
  1. 1.Intensive Care DepartmentHôpital André MignotLe ChesnayFrance
  2. 2.Neurology Department and Stroke CenterHôpital André MignotLe ChesnayFrance
  3. 3.Intensive Care DepartmentHôpital St LouisParisFrance

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