Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological condition, generally observed in conjunction with severe and acute hypertension, that involves mainly the posterior head areas (occipital and temporal lobes) and anterior “watershed” areas. In this syndrome it is rare to observe a predominant involvement of the brainstem. We describe the clinical and radiological findings in a patient with brainstem involvement, discussing its pathophysiological features and possible differential diagnosis.
SchwartzRBJonesKMKalinaP. Hypertensive encephalopathy: Findings on CT, MR imaging, and SPECT imaging in 14 cases. AJR Am J Roentgenol1992; 159: 379–383.
3.
HincheyJChavesCAppignaniB. A reversible posterior leukoencephalopathy syndrome. N Engl J Med1996; 334: 494–500.
4.
CalhounDAOparilS. Treatment of hypertensive crisis. N EngI J Med1990; 323: 1177–1183.
ProvenzaleJMPetrellaJRCruzLCJr. Quantitative assessment of diffusion abnormalities in posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol2001; 22: 1455–1461.
8.
AmbrosettoPNicoliniFZoliM. Ophthalmoplegic migraine: From questions to answers. Cephalalgia2014; 34: 914–919.
9.
MoscatoGCirilloLDall'olioM. Management of unruptured brain aneurysms: Retrospective analysis of a single centre experience. Neuroradiol J2013; 26: 315–319.
10.
ServilloGBifulcoFDe RobertisE. Posterior reversible encephalopathy syndrome in intensive care medicine. Intensive Care Med2007; 33: 230–236.
KitaguchiHTomimotoHMikiY. A brainstem variant of reversible posterior leukoencephalopathy syndrome. Neuroradiology2005; 47: 652–656.
13.
ServilloGStrianoPStrianoS. Posterior reversible encephalopathy syndrome (PRES) in critically ill obstetric patients. Intensive Care Med2003; 29: 2323–2326.
14.
StottVLHurrellMAAndersonTJ. Reversible posterior leukoencephalopathy syndrome: A misnomer reviewed. Intern Med J2005; 35: 83–90.
15.
TrommerBLHomerDMikhaelMA. Cerebral vasospasm and eclampsia. Stroke1988; 19: 326–329.
16.
HauserRALaceyDMKnightMR. Hypertensive encephalopathy: Magnetic resonance imaging demonstration of reversible cortical and white matter lesions. Arch Neurol1988; 45: 1078–1083.
17.
The Magpie Trial Collaborative Group. Do women with pre-eclampsia, and their babies, benefit from magnesium sulphate? The Magpie Trial: a randomised placebo-controlled trial. Lancet2002; 359: 1877–1890.
18.
GiffordAW. Management of hypertensive crises. JAMA1991; 266: 829–835.
