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Acute Hypertensive Encephalopathy, PRES
Luke L. Linscott, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Posterior reversible encephalopathy syndrome (PRES)
            • Synonyms

              • Hypertensive encephalopathy
              • Reversible posterior leukoencephalopathy syndrome (RPLS)
            • Definitions

              • Cerebrovascular autoregulatory disorder
                • Multiple etiologies
                • Most cases associated with acute hypertension (HTN)
                • Symptoms: Headache, visual disturbances, altered mental function, & seizures

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          • Gross Pathologic & Surgical Features

                            • Microscopic Features

                              CLINICAL ISSUES

                              • Presentation

                                • Demographics

                                  • Natural History & Prognosis

                                    • Treatment

                                      DIAGNOSTIC CHECKLIST

                                      • Consider

                                        • Image Interpretation Pearls

                                          Selected References

                                          1. Ollivier M et al: Neuroimaging features in posterior reversible encephalopathy syndrome: A pictorial review. J Neurol Sci. 373:188-200, 2017
                                          2. Habetz K et al: Posterior reversible encephalopathy syndrome: A comparative study of pediatric versus adult Patients. Pediatr Neurol. 65:45-51, 2016
                                          3. Dandoy CE et al: Clinical Utility of Computed Tomography and Magnetic Resonance Imaging for Diagnosis of Posterior Reversible Encephalopathy Syndrome after Stem Cell Transplantation in Children and Adolescents. Biol Blood Marrow Transplant. 21(11):2028-32, 2015
                                          4. Pereira PR et al: Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndrome. Arq Neuropsiquiatr. 73(1):36-40, 2015
                                          5. Thompson RJ et al: Posterior reversible encephalopathy syndrome in the emergency department: case series and literature review. West J Emerg Med. 16(1):5-10, 2015
                                          6. Yamamoto H et al: Clinical and neuroimaging findings in children with posterior reversible encephalopathy syndrome. Eur J Paediatr Neurol. 19(6):672-8, 2015
                                          7. Gao B et al: Central-variant posterior reversible encephalopathy syndrome: more than meets the eye. AJR Am J Roentgenol. 203(4):W454, 2014
                                          8. Lamy C et al: Posterior reversible encephalopathy syndrome. Handb Clin Neurol. 121:1687-701, 2014
                                          9. Rykken JB et al: Posterior reversible encephalopathy syndrome. Semin Ultrasound CT MR. 35(2):118-35, 2014
                                          10. Li R et al: Is hypertension predictive of clinical recurrence in posterior reversible encephalopathy syndrome? J Clin Neurosci. 20(2):248-52, 2013
                                          11. McKinney AM et al: Detection of microhemorrhage in posterior reversible encephalopathy syndrome using susceptibility-weighted imaging. AJNR Am J Neuroradiol. 33(5):896-903, 2012
                                          12. Peter P et al: Posterior reversible encephalopathy syndrome and the pediatric population. J Pediatr Neurosci. 7(2):136-8, 2012
                                          13. McCoy B et al: Childhood posterior reversible encephalopathy syndrome. Eur J Paediatr Neurol. 15(2):91-4, 2011
                                          14. Hefzy HM et al: Hemorrhage in posterior reversible encephalopathy syndrome: imaging and clinical features. AJNR Am J Neuroradiol. 30(7):1371-9, 2009
                                          15. Bartynski WS: Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol. 29(6):1043-9, 2008
                                          16. Bartynski WS: Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. AJNR Am J Neuroradiol. 29(6):1036-42, 2008
                                          17. Bartynski WS et al: Posterior reversible encephalopathy syndrome in infection, sepsis, and shock. AJNR Am J Neuroradiol. 27(10):2179-90, 2006
                                          18. Ishikura K et al: Posterior reversible encephalopathy syndrome in children: its high prevalence and more extensive imaging findings. Am J Kidney Dis. 48(2):231-8, 2006
                                          19. Pande AR et al: Clinicoradiological factors influencing the reversibility of posterior reversible encephalopathy syndrome: a multicenter study. Radiat Med. 24(10):659-68, 2006
                                          Related Anatomy
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                                          Related Differential Diagnoses
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                                          References
                                          Tables

                                          Tables

                                          KEY FACTS

                                          • Terminology

                                            • Imaging

                                              • Top Differential Diagnoses

                                                • Pathology

                                                  • Clinical Issues

                                                    TERMINOLOGY

                                                    • Abbreviations

                                                      • Posterior reversible encephalopathy syndrome (PRES)
                                                    • Synonyms

                                                      • Hypertensive encephalopathy
                                                      • Reversible posterior leukoencephalopathy syndrome (RPLS)
                                                    • Definitions

                                                      • Cerebrovascular autoregulatory disorder
                                                        • Multiple etiologies
                                                        • Most cases associated with acute hypertension (HTN)
                                                        • Symptoms: Headache, visual disturbances, altered mental function, & seizures

                                                    IMAGING

                                                    • General Features

                                                      • CT Findings

                                                        • MR Findings

                                                          • Nuclear Medicine Findings

                                                            • Imaging Recommendations

                                                              DIFFERENTIAL DIAGNOSIS

                                                                PATHOLOGY

                                                                • General Features

                                                                  • Gross Pathologic & Surgical Features

                                                                    • Microscopic Features

                                                                      CLINICAL ISSUES

                                                                      • Presentation

                                                                        • Demographics

                                                                          • Natural History & Prognosis

                                                                            • Treatment

                                                                              DIAGNOSTIC CHECKLIST

                                                                              • Consider

                                                                                • Image Interpretation Pearls

                                                                                  Selected References

                                                                                  1. Ollivier M et al: Neuroimaging features in posterior reversible encephalopathy syndrome: A pictorial review. J Neurol Sci. 373:188-200, 2017
                                                                                  2. Habetz K et al: Posterior reversible encephalopathy syndrome: A comparative study of pediatric versus adult Patients. Pediatr Neurol. 65:45-51, 2016
                                                                                  3. Dandoy CE et al: Clinical Utility of Computed Tomography and Magnetic Resonance Imaging for Diagnosis of Posterior Reversible Encephalopathy Syndrome after Stem Cell Transplantation in Children and Adolescents. Biol Blood Marrow Transplant. 21(11):2028-32, 2015
                                                                                  4. Pereira PR et al: Clinical, imagiological and etiological spectrum of posterior reversible encephalopathy syndrome. Arq Neuropsiquiatr. 73(1):36-40, 2015
                                                                                  5. Thompson RJ et al: Posterior reversible encephalopathy syndrome in the emergency department: case series and literature review. West J Emerg Med. 16(1):5-10, 2015
                                                                                  6. Yamamoto H et al: Clinical and neuroimaging findings in children with posterior reversible encephalopathy syndrome. Eur J Paediatr Neurol. 19(6):672-8, 2015
                                                                                  7. Gao B et al: Central-variant posterior reversible encephalopathy syndrome: more than meets the eye. AJR Am J Roentgenol. 203(4):W454, 2014
                                                                                  8. Lamy C et al: Posterior reversible encephalopathy syndrome. Handb Clin Neurol. 121:1687-701, 2014
                                                                                  9. Rykken JB et al: Posterior reversible encephalopathy syndrome. Semin Ultrasound CT MR. 35(2):118-35, 2014
                                                                                  10. Li R et al: Is hypertension predictive of clinical recurrence in posterior reversible encephalopathy syndrome? J Clin Neurosci. 20(2):248-52, 2013
                                                                                  11. McKinney AM et al: Detection of microhemorrhage in posterior reversible encephalopathy syndrome using susceptibility-weighted imaging. AJNR Am J Neuroradiol. 33(5):896-903, 2012
                                                                                  12. Peter P et al: Posterior reversible encephalopathy syndrome and the pediatric population. J Pediatr Neurosci. 7(2):136-8, 2012
                                                                                  13. McCoy B et al: Childhood posterior reversible encephalopathy syndrome. Eur J Paediatr Neurol. 15(2):91-4, 2011
                                                                                  14. Hefzy HM et al: Hemorrhage in posterior reversible encephalopathy syndrome: imaging and clinical features. AJNR Am J Neuroradiol. 30(7):1371-9, 2009
                                                                                  15. Bartynski WS: Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol. 29(6):1043-9, 2008
                                                                                  16. Bartynski WS: Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. AJNR Am J Neuroradiol. 29(6):1036-42, 2008
                                                                                  17. Bartynski WS et al: Posterior reversible encephalopathy syndrome in infection, sepsis, and shock. AJNR Am J Neuroradiol. 27(10):2179-90, 2006
                                                                                  18. Ishikura K et al: Posterior reversible encephalopathy syndrome in children: its high prevalence and more extensive imaging findings. Am J Kidney Dis. 48(2):231-8, 2006
                                                                                  19. Pande AR et al: Clinicoradiological factors influencing the reversibility of posterior reversible encephalopathy syndrome: a multicenter study. Radiat Med. 24(10):659-68, 2006