Tags

Type your tag names separated by a space and hit enter

Isolated cerebellar involvement in posterior reversible encephalopathy syndrome.
J Neurol Sci. 2015 Oct 15; 357(1-2):101-5.JN

Abstract

BACKGROUND

Posterior reversible encephalopathy syndrome (PRES) is a serious and increasingly recognized disorder in humans. However, isolated cerebellar involvement in PRES is extremely uncommon. In this study, we sought to investigate its clinical and radiological features by describing a cohort of cases with PRES and isolated cerebellar involvement.

METHODS

We report 2 patients with PRES with only cerebellar involvement and identified additional 9 cases using the PubMed database with the MeSH terms "posterior reversible encephalopathy syndrome", "hypertensive encephalopathy", "hypertension", "cerebellum", "encephalopathy", and "magnetic resonance imaging". We then collectively analyzed the clinical and imaging characteristics of these 11 cases.

RESULTS

The average age was 28years, with 8 male and 3 female patients. All cases had severe acute hypertension and T2 hyperintensity on MRI exclusively centered within the cerebellum. Of 11 patients, 7 had hypertensive retinopathy, a favorable clinical course with only antihypertensive treatment, and resolution of the cerebellar lesions on follow-up imaging. A total of 5 of the 11 patients received external ventricular drainage due to obstructive hydrocephalus and only 2 of the 11 had a seizure.

CONCLUSIONS

Isolated cerebellar involvement in PRES may be a unique variant that affects younger, male cases with severe acute hypertension and hypertensive retinopathy, but not necessarily seizure. Most patients have full recovery after fast control of blood pressure. Awareness of atypical neuroimaging features in PRES is critical for appropriate treatment.

Authors+Show Affiliations

Department of Pathology, Henan Provincial People's Hospital, People's Hospital of Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, Henan 450003, PR China.Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave., Wuhan, Hubei 430030, PR China.Department of Neurology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1095 Jiefang Ave., Wuhan, Hubei 430030, PR China. Electronic address: zhusuiqiang@gmail.com.

Pub Type(s)

Case Reports
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

26163418

Citation

Li, Dujuan, et al. "Isolated Cerebellar Involvement in Posterior Reversible Encephalopathy Syndrome." Journal of the Neurological Sciences, vol. 357, no. 1-2, 2015, pp. 101-5.
Li D, Lian L, Zhu S. Isolated cerebellar involvement in posterior reversible encephalopathy syndrome. J Neurol Sci. 2015;357(1-2):101-5.
Li, D., Lian, L., & Zhu, S. (2015). Isolated cerebellar involvement in posterior reversible encephalopathy syndrome. Journal of the Neurological Sciences, 357(1-2), 101-5. https://doi.org/10.1016/j.jns.2015.07.004
Li D, Lian L, Zhu S. Isolated Cerebellar Involvement in Posterior Reversible Encephalopathy Syndrome. J Neurol Sci. 2015 Oct 15;357(1-2):101-5. PubMed PMID: 26163418.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Isolated cerebellar involvement in posterior reversible encephalopathy syndrome. AU - Li,Dujuan, AU - Lian,Lifei, AU - Zhu,Suiqiang, Y1 - 2015/07/03/ PY - 2015/01/21/received PY - 2015/06/15/revised PY - 2015/07/02/accepted PY - 2015/7/12/entrez PY - 2015/7/15/pubmed PY - 2016/9/14/medline KW - Cerebellum KW - Headache KW - Hypertension KW - Hypertensive encephalopathy KW - Magnetic resonance imaging KW - Posterior reversible encephalopathy syndrome SP - 101 EP - 5 JF - Journal of the neurological sciences JO - J Neurol Sci VL - 357 IS - 1-2 N2 - BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a serious and increasingly recognized disorder in humans. However, isolated cerebellar involvement in PRES is extremely uncommon. In this study, we sought to investigate its clinical and radiological features by describing a cohort of cases with PRES and isolated cerebellar involvement. METHODS: We report 2 patients with PRES with only cerebellar involvement and identified additional 9 cases using the PubMed database with the MeSH terms "posterior reversible encephalopathy syndrome", "hypertensive encephalopathy", "hypertension", "cerebellum", "encephalopathy", and "magnetic resonance imaging". We then collectively analyzed the clinical and imaging characteristics of these 11 cases. RESULTS: The average age was 28years, with 8 male and 3 female patients. All cases had severe acute hypertension and T2 hyperintensity on MRI exclusively centered within the cerebellum. Of 11 patients, 7 had hypertensive retinopathy, a favorable clinical course with only antihypertensive treatment, and resolution of the cerebellar lesions on follow-up imaging. A total of 5 of the 11 patients received external ventricular drainage due to obstructive hydrocephalus and only 2 of the 11 had a seizure. CONCLUSIONS: Isolated cerebellar involvement in PRES may be a unique variant that affects younger, male cases with severe acute hypertension and hypertensive retinopathy, but not necessarily seizure. Most patients have full recovery after fast control of blood pressure. Awareness of atypical neuroimaging features in PRES is critical for appropriate treatment. SN - 1878-5883 UR - https://www.unboundmedicine.com/medline/citation/26163418/Isolated_cerebellar_involvement_in_posterior_reversible_encephalopathy_syndrome_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-510X(15)00425-6 DB - PRIME DP - Unbound Medicine ER -