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Tumour-like presentation of atypical posterior reversible encephalopathy syndrome with prominent brainstem involvement.
BMJ Case Rep. 2020 Jan 08; 13(1)BC

Abstract

Typical posterior reversible encephalopathy syndrome (PRES) is a clinical-neuroradiological entity characterised by bilateral white matter oedema, which is usually symmetrical and totally reversible in 2-3 weeks. A 46-year-old man presented with a persistent headache and visual blurring in the right eye. On admission, the clinical examination revealed minimal unsteadiness of gait and elevated blood pressure. A brain MRI showed a hyperintense signal on T2-weighted sequences in the whole brainstem, extended to the spinal cord (C2-C6), the left insula and the right cerebellum. When his blood pressure was controlled, his symptoms gradually improved. The follow-up MRI scan at 3 weeks revealed a dramatic regression of the hyperintense lesions on T2-weighted sequences. The differential diagnosis of PRES is very wide, especially in the case of conspicuous brainstem involvement. Treatable causes of white matter oedema should be always kept in mind to avoid misdiagnosis and prevent complications, such as intracranial haemorrhage.

Authors+Show Affiliations

Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy vincenzo19689@gmail.com.Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.Department of Neuroscience, Imaging and Clinical Sciences, "G. d'Annunzio" University, Chieti, Italy.Depatment of Neurology, "SS. Annunziata" Hospital, Chieti, Italy.

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

31919058

Citation

Di Stefano, Vincenzo, et al. "Tumour-like Presentation of Atypical Posterior Reversible Encephalopathy Syndrome With Prominent Brainstem Involvement." BMJ Case Reports, vol. 13, no. 1, 2020.
Di Stefano V, Rispoli MG, Onofrj M, et al. Tumour-like presentation of atypical posterior reversible encephalopathy syndrome with prominent brainstem involvement. BMJ Case Rep. 2020;13(1).
Di Stefano, V., Rispoli, M. G., Onofrj, M., & De Angelis, M. V. (2020). Tumour-like presentation of atypical posterior reversible encephalopathy syndrome with prominent brainstem involvement. BMJ Case Reports, 13(1). https://doi.org/10.1136/bcr-2019-231687
Di Stefano V, et al. Tumour-like Presentation of Atypical Posterior Reversible Encephalopathy Syndrome With Prominent Brainstem Involvement. BMJ Case Rep. 2020 Jan 8;13(1) PubMed PMID: 31919058.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Tumour-like presentation of atypical posterior reversible encephalopathy syndrome with prominent brainstem involvement. AU - Di Stefano,Vincenzo, AU - Rispoli,Marianna Gabriella, AU - Onofrj,Marco, AU - De Angelis,Maria Vittoria, Y1 - 2020/01/08/ PY - 2022/01/08/pmc-release PY - 2020/1/11/entrez PY - 2020/1/11/pubmed PY - 2020/8/20/medline KW - Brain stem/cerebellum KW - neuro-oncology KW - neuroimaging KW - neurology KW - radiology JF - BMJ case reports JO - BMJ Case Rep VL - 13 IS - 1 N2 - Typical posterior reversible encephalopathy syndrome (PRES) is a clinical-neuroradiological entity characterised by bilateral white matter oedema, which is usually symmetrical and totally reversible in 2-3 weeks. A 46-year-old man presented with a persistent headache and visual blurring in the right eye. On admission, the clinical examination revealed minimal unsteadiness of gait and elevated blood pressure. A brain MRI showed a hyperintense signal on T2-weighted sequences in the whole brainstem, extended to the spinal cord (C2-C6), the left insula and the right cerebellum. When his blood pressure was controlled, his symptoms gradually improved. The follow-up MRI scan at 3 weeks revealed a dramatic regression of the hyperintense lesions on T2-weighted sequences. The differential diagnosis of PRES is very wide, especially in the case of conspicuous brainstem involvement. Treatable causes of white matter oedema should be always kept in mind to avoid misdiagnosis and prevent complications, such as intracranial haemorrhage. SN - 1757-790X UR - https://www.unboundmedicine.com/medline/citation/31919058/Tumour_like_presentation_of_atypical_posterior_reversible_encephalopathy_syndrome_with_prominent_brainstem_involvement_ L2 - https://casereports.bmj.com/lookup/pmidlookup?view=long&pmid=31919058 DB - PRIME DP - Unbound Medicine ER -