Critical Care and Shock

Posterior Reversible Encephalopathy Syndrome: A Review

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Posterior reversible encephalopathy syndrome (PRES) is a clinical-neuroradiological entity characterized by headache, vomiting, altered mental status, blurred vision and seizures as well as images suggesting white-gray matter edema involving in most cases posterior regions of the central nervous system, as demonstrated by magnetic resonance image. The development of PRES is most commonly associated with hypertensive encephalopathy, preeclampsia-eclampsia and hemolysis, elevated liver enzymes, low platelets (HELLP) syndrome, and immunosuppressive/cytotoxic drugs. While usually reversible, the early recognition and treatment of this syndrome is important to prevent permanent neurological sequelae. The treatment is based in the management or withdrawal of the triggering factor. In this manuscript we will briefly review the pathogenesis, clinical scenario, diagnostic studies and management of PRES.

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