Posterior reversible encephalopathy syndrome in intensive care medicine |
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Authors: | Giuseppe Servillo Francesca Bifulco Edoardo De Robertis Ornella Piazza Pasquale Striano Fabio Tortora Salvatore Striano Rosalba Tufano |
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Affiliation: | (1) Medical Intensive Care Unit, Department of Surgical and Anesthesiological Sciences, Naples, Italy;(2) Epilepsy Centre, Department of Neurological Sciences, Federico II University, Naples, Italy;(3) Service of Neuroradiology, Federico II University, Naples, Italy |
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Abstract: | Background Posterior reversible encephalopathy syndrome (PRES) is a well-recognized clinico-neuroradiological transient condition. Early recognition is of paramount importance for prompt control of blood pressure or removal of precipitating factors and treatment of epileptic seizures or status epilepticus. Delay in the diagnosis and treatment may in fact results in death or in irreversible neurological sequelae. Discussion PRES is characterized by headache, altered mental status, seizures, and visual disturbances and is associated with a number of different causes, most commonly acute hypertension, preeclampsia/eclampsia, and immunosuppressive agents. Clinical symptoms and neuroradiological findings are typically indistinguishable among the cases of PRES, regardless of underlying cause. Magnetic resonance studies typically show edema involving the white matter of cerebral posterior regions, especially parieto-occipital lobes but frontal and temporal lobes, and other encephalic structures may be involved. Conclusions Intensivists and other physicians involved in the evaluation of patients with presumed PRES must be aware of the clinical spectrum of the associated conditions, the diagnostic modalities, and the correct treatment. |
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Keywords: | Posterior reversible encephalopathy syndrome Intensive care Magnetic resonance imaging Encephalopathy Eclampsia |
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