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2017 ; 2017
(4
): omx011
Nephropedia Template TP
Sudulagunta SR
; Sodalagunta MB
; Kumbhat M
; Settikere Nataraju A
Oxf Med Case Reports
2017[Apr]; 2017
(4
): omx011
PMID28473920
show ga
Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological
syndrome characterized by a headache, seizures, altered mental status and visual
loss and characterized by white matter vasogenic edema affecting the posterior
occipital and parietal lobes of the brain predominantly. This clinical syndrome
is increasingly recognized due to improvement and availability of brain imaging
specifically magnetic resonance imaging (MRI). A 35-year-old female with the
history of unsafe abortion and massive blood transfusion 10 days ago was brought
to the emergency room with three episodes of generalized tonic-clonic seizures,
urinary incontinence and altered sensorium since 3 hours. MRI brain showed
bilateral occipital, parietal, frontal cortex and subcortical white matter
T2/Fluid-attenuated inversion recovery hyperintensities, suggestive of PRES. The
patient improved after management with intravenous fluids, antibiotics,
antiepileptics and monitoring of blood pressure. If recognized and treated early,
the clinical syndrome commonly resolves within a week. PRES can be a major
problem in rapid and massive blood transfusion. A high index of suspicion and
prompt treatment can reduce morbidity, mortality and pave the path for early
recovery.
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