Acute obstructive hydrocephalus in posterior reversible encephalopathy syndrome

Posterior reversible encephalopathy syndrome (PRES) is an uncommon, subacute neurological disorder that presents radiologically with a pattern of bilateral parieto-occipital areas of vasogenic oedema. Conditions commonly associated with PRES include autoimmune disorders, cytotoxic drugs, metabolic...

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Main Authors: J Hiesgen, T N Annor
Format: Article
Language:English
Published: South African Medical Association 2022-12-01
Series:South African Medical Journal
Subjects:
Online Access:https://samajournals.co.za/index.php/samj/article/view/634
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author J Hiesgen
T N Annor
author_facet J Hiesgen
T N Annor
author_sort J Hiesgen
collection DOAJ
description Posterior reversible encephalopathy syndrome (PRES) is an uncommon, subacute neurological disorder that presents radiologically with a pattern of bilateral parieto-occipital areas of vasogenic oedema. Conditions commonly associated with PRES include autoimmune disorders, cytotoxic drugs, metabolic abnormalities and, most frequently, hypertensive emergencies. Clinically, headache, visual disturbances, seizures and an altered level of consciousness are often reported. The outcome is favourable if the underlying cause is addressed. Posterior fossa involvement resulting in obstructive hydrocephalus is a rare presentation and may be misdiagnosed as a mass lesion or infection, leading to delayed or unnecessary treatment. We describe the clinical presentation, findings on neuroimaging and conservative management of a man with PRES resulting in severe cerebellar oedema and acute obstructive hydrocephalus. This case illustrates that awareness of atypical neuroimaging in PRES is important for the management of these patients and to avoid morbidity and mortality.
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spelling doaj.art-799945a37de7458c861098a0ac484f502024-01-02T08:25:59ZengSouth African Medical AssociationSouth African Medical Journal0256-95742078-51352022-12-01113110.7196/SAMJ.2023.v113i1.16744Acute obstructive hydrocephalus in posterior reversible encephalopathy syndromeJ Hiesgen0T N Annor1Department of Neurology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South AfricaDepartment of Radiology, School of Medicine, Faculty of Health Sciences, University of Pretoria, South Africa Posterior reversible encephalopathy syndrome (PRES) is an uncommon, subacute neurological disorder that presents radiologically with a pattern of bilateral parieto-occipital areas of vasogenic oedema. Conditions commonly associated with PRES include autoimmune disorders, cytotoxic drugs, metabolic abnormalities and, most frequently, hypertensive emergencies. Clinically, headache, visual disturbances, seizures and an altered level of consciousness are often reported. The outcome is favourable if the underlying cause is addressed. Posterior fossa involvement resulting in obstructive hydrocephalus is a rare presentation and may be misdiagnosed as a mass lesion or infection, leading to delayed or unnecessary treatment. We describe the clinical presentation, findings on neuroimaging and conservative management of a man with PRES resulting in severe cerebellar oedema and acute obstructive hydrocephalus. This case illustrates that awareness of atypical neuroimaging in PRES is important for the management of these patients and to avoid morbidity and mortality. https://samajournals.co.za/index.php/samj/article/view/634PRESDrugs
spellingShingle J Hiesgen
T N Annor
Acute obstructive hydrocephalus in posterior reversible encephalopathy syndrome
South African Medical Journal
PRES
Drugs
title Acute obstructive hydrocephalus in posterior reversible encephalopathy syndrome
title_full Acute obstructive hydrocephalus in posterior reversible encephalopathy syndrome
title_fullStr Acute obstructive hydrocephalus in posterior reversible encephalopathy syndrome
title_full_unstemmed Acute obstructive hydrocephalus in posterior reversible encephalopathy syndrome
title_short Acute obstructive hydrocephalus in posterior reversible encephalopathy syndrome
title_sort acute obstructive hydrocephalus in posterior reversible encephalopathy syndrome
topic PRES
Drugs
url https://samajournals.co.za/index.php/samj/article/view/634
work_keys_str_mv AT jhiesgen acuteobstructivehydrocephalusinposteriorreversibleencephalopathysyndrome
AT tnannor acuteobstructivehydrocephalusinposteriorreversibleencephalopathysyndrome