PDF(Pubmed)
Abstract：
We present a case of infratentorial variant posterior reversible encephalopathy syndrome (PRES), which is a very rare presentation of PRES. Atypical PRES is more common than the typical parieto-occipital PRES. We present a 43-year-old male who presented with acute change in mentation, left gaze deviation, and paraparesis with initial blood pressures of 230/120 with anasarca. In the present admission, his CT showed diffuse infratentorial hypodensity. Computed tomography angiography (CTA) was negative for large vessel occlusion. MRI of the brain without contrast showed fluid-attenuated inversion recovery (FLAIR) change diffusely in the brainstem but also extended to the cerebellum and occipital lobe, along with diffusion restriction seen in different regions, including the brainstem and cortex. The patient improved clinically with the improvement of blood pressure and follow-up imaging in five weeks showed improvement of imaging findings. This presentation helps understand the approach to patients presenting with brainstem edema in the acute phase.
摘要：
我们介绍了一例幕下变异型可逆性后部脑病综合征（PRES），这是一个非常罕见的PRES的介绍。非典型PRES比典型的顶枕骨PRES更常见。我们介绍了一名43岁的男性，他表现出严重的精神错乱，左注视偏差,和截瘫，初始血压为230/120，伴有anasarca。在目前的承认中，他的CT显示弥漫性幕下低密度。计算机断层扫描血管造影（CTA）对大血管闭塞呈阴性。无对比的大脑MRI显示脑干弥漫性液体衰减倒置恢复（FLAIR）改变，但也延伸到小脑和枕叶，随着在不同地区看到的扩散限制，包括脑干和皮质.患者在临床上随着血压的改善而改善，并且在五周的随访影像学表现出影像学发现的改善。本报告有助于了解急性期脑干水肿患者的治疗方法。
