Background
Posterior reversible encephalopathy syndrome (PRES) is a well-recognized complication
of hypertensive encephalopathy. Recently, pre-eclampsia, connective tissue disorders,
and immunosuppressive drugs have been reported to be the etiologies of this rare syndrome.
Methods
We evaluated 9 cases of PRES whose diagnosis were confirmed based on clinical and
radiologic evidence between July 2011 and December 2013 in a tertiary center, Imam
Khomeini Hospital, Tehran, Iran.
Results
Immunosuppressive drugs, especially cyclosporine, and hypertension were the main precipitating
factors. In this study, seizure was the most common clinical presentation (100%),
whereas other common clinical presentations were confusion (78%), visual loss (67%),
and headaches (67%). With conservative management and elimination of predisposing
factor, the patients improved gradually except for 2 cases who experienced prolonged
recovery period because of delayed diagnosis.
Conclusions
With timely diagnosis, PRES generally has a good prognosis with complete recovery.
However, in missed conditions, it could be associated with catastrophic burden especially
in organ transplantation after a prolonged time spending to find matched donors or
in chronic immunosuppressive conditions. Thereupon, physicians should be aware of
clinical and radiologic manifestations of this preventable but potentially disabling
syndrome.
Key Words
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Article info
Publication history
Published online: June 13, 2015
Accepted:
February 10,
2015
Received in revised form:
February 3,
2015
Received:
January 6,
2015
Footnotes
Authors declare that there is no conflict of interest.
All authors read the article with a critical view and were involved in collecting of data and designing and writing of the article.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2015.02.014
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
