Journal Article10.1056/NEJM199602223340803
A reversible posterior leukoencephalopathy syndrome
Judy Hinchey,Claudia Chaves,B A Appignani,Joan Breen,Linda Pao,Annabel Wang,Michael S. Pessin,Catherine Lamy,Jean-Louis Mas,Louis R. Caplan +9 more
TL;DR: Reversible, predominantly posterior leukoencephalopathy may develop in patients who have renal insufficiency or hypertension or who are immunosuppressed and the findings on neuroimaging are characteristic of subcortical edema without infarction.
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Abstract: Background and Methods In some patients who are hospitalized for acute illness, we have noted a reversible syndrome of headache, altered mental functioning, seizures, and loss of vision associated with findings indicating predominantly posterior leukoencephalopathy on imaging studies. To elucidate this syndrome, we searched the log books listing computed tomographic (CT) and magnetic resonance imaging (MRI) studies performed at the New England Medical Center in Boston and Hopital Sainte Anne in Paris; we found 15 such patients who were evaluated from 1988 through 1994. Results Of the 15 patients, 7 were receiving immunosuppressive therapy after transplantation or as treatment for aplastic anemia, 1 was receiving interferon for melanoma, 3 had eclampsia, and 4 had acute hypertensive encephalopathy associated with renal disease (2 with lupus nephritis, 1 with acute glomerulonephritis, and 1 with acetaminophen-induced hepatorenal failure). Altogether, 12 patients had abrupt increases in blood pressure, and 8...
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Reversible cerebral vasoconstriction syndrome
TL;DR: Reversible cerebral vasoconstriction syndrome is characterised by severe headaches with or without seizures and focal neurological deficits, and constriction of cerebral arteries which resolves spontaneously in 1–3 months, with no definite effect on the haemorrhagic and ischaemic complications.
274
Catheter Angiography, MR Angiography, and MR Perfusion in Posterior Reversible Encephalopathy Syndrome
TL;DR: Vasculopathy was a common finding on CA and MRA in the authors' patients with PRES, and MRP demonstrated reduced cortical rCBV in PRES lesions, and Vasogenic edema was reduced in patients with hypertension, and superior distal PCA visualization correlated with reduced hemispheric edema in Patients with PRES and severe hypertension.
The posterior reversible encephalopathy syndrome: what's certain, what's new?
TL;DR: Seizures do not normally progress to chronic epilepsy so antiepileptic drugs should be discontinued after about 3 months, and recovery within a few days, while the MRI abnormalities resolve much more slowly.
254
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