Brainstem and Upper Cervical Cord Involvement in a Patient With Posterior Reversible Encephalopathy Syndrome: Neuro-Images Publisher Pubmed



Ghaderi Yazdi B¹ ; Hadei J¹ ; Malekian N¹
Source: Neurological Sciences Published:2023

Abstract

Introduction: Posterior reversible encephalopathy syndrome (PRES) is a clinicoradiological syndrome with acute heterogeneous neurological symptoms. It is usually preceded by hypertension or chemotherapy. Brain magnetic resonance imaging (MRI) shows vasogenic edema over the cortex and subcortex of parieto-occipital lobes. Involvement of the brainstem, basal ganglia, and spinal cord is rare. Material: Here we described an 18 years old woman with a history of systemic lupus erythematosus who was admitted due seizure and impaired consciousness. She had a mean arterial pressure of 160 and previously received cyclophosphamide. Results: She had a unique involvement of diffuse bilateral asymmetric brain edema over the upper cervical cord, brainstem, cerebellum, thalami, basal ganglia, frontotemporal, and parieto-occipital lobes. She was diagnosed with PRES and after the treatment vasogenic edema vanished completely. Conclusion: When it is clinically applicable, physicians should consider PRES as the differential diagnosis of vasogenic edema over the upper cervical cord, cerebellum, and brainstem. © 2023, Fondazione Societa Italiana di Neurologia.