Evaluation of Clinical Manifestations, Radiological Features, and Outcomes of Posterior Reversible Encephalopathy Syndrome (PRES)
Abstract
Introduction: Posterior reversible encephalopathy syndrome (PRES) is a state coupled with a unique clinical and radiological appearance. Various conditions such as preeclampsia/eclampsia, autoimmune diseases, chemotherapy bone marrow and organ transplantation are foreseen and this clinical condition is better illuminated along with imaging, clinical and laboratory features. Therefore, the aim of this study is to describe the clinical and radiological manifestations, diagnosis, and outcome of PRES.
Material and methods: A retrospective review of cases of PRES over five years. Patient characteristics, including demographics, comorbidities, specific therapy, and clinical outcome, were analyzed. Diagnosis was made by clinical examination and imaging techniques.
Results: Fifteen patients detected PRES between 2015 and 2020 were included. In fifteen patients, the median age was 49.9±17.0 years (25-77 years), 33.3% were men, and 66.7% were women. Two of the patients had active cancer, none had a history of bone marrow or organ transplantation, three had autoimmune disease, four were peripartum, two had chronic renal failure, three had a systemic disease such as hypertension and diabetes, and one had respiratory infection. MR imaging showed vasogenic edema at 100% and restricted diffusions at 33,3%. CT image showed hemorrhage of 30% additionally. Antiedema and convulsion therapy was administered at 100%. Overall, 86,6% of our patients recovered without sequelae in short term. The rate of individuals aged 50 and over was statistically significantly poor in terms of long-term results compared to the group under 50 years of age individuals (p=0.041).
Conclusion: In this retrospective analysis of PRES patients, the prognosis was good. CT and MRI contribute to the diagnosis, and various imaging findings can be seen. While the patient's age has an important place in determining the prognosis, other radiological or demographic parameters do not have any effect on short-term or long-term results.
Keywords
computed tomography, magnetic resonance imaging, posterior reversible encephalopathy, syndrome, edema, convulsion, hypertension
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