|LETTER TO EDITOR
|Year : 2019 | Volume
| Issue : 2 | Page : 128-129
Posterior reversible encephalopathy syndrome and eclampsia: Neuroimaging features
Jamir Pitton Rissardo, Ana Letícia Fornari Caprara
Department of Neurology; Department of Medicine, Federal University of Santa Maria, Santa Maria, Brazil
|Date of Web Publication||14-Jan-2020|
Jamir Pitton Rissardo
Rua Roraima, Santa Maria, Rio Grande do Sul
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rissardo JP, Fornari Caprara AL. Posterior reversible encephalopathy syndrome and eclampsia: Neuroimaging features. J Curr Res Sci Med 2019;5:128-9
|How to cite this URL:|
Rissardo JP, Fornari Caprara AL. Posterior reversible encephalopathy syndrome and eclampsia: Neuroimaging features. J Curr Res Sci Med [serial online] 2019 [cited 2020 Apr 4];5:128-9. Available from: http://www.jcrsmed.org/text.asp?2019/5/2/128/275786
We read an article on “Journal of Current Research in Scientific Medicine” with great interest. Sivaguru et al. reported a case of an adult female who developed posterior reversible encephalopathy syndrome (PRES) on her 8th day of postpartum along with subarachnoid hemorrhage.
PRES is a rare but severe condition of the central nervous system, which has a distinctive neuroimaging. In the last decades, numerous reports have been published. In this context, epidemiological data should be interpreted with caution, since the syndrome is probably underdiagnosed due to the variety in clinical presentations, radiological findings, and underlying risk factors.
We would like to address some important points that together with the study of Sivaguru et al. could lead to a better understanding of this disorder. In a review about PRES, it was found that a significant number of patients with eclampsia will have changes compatible with PRES once diagnosed by appropriate imaging such as magnetic resonance imaging (MRI) scan of the brain in T2 fluid-attenuated inversion recovery-sequence. In this way, neuroimaging alone could not rule out the diagnosis of PRES secondary to a preeclamptic state, even if petechial cortical hemorrhages or cerebral venous thrombosis may occur. Therefore, some experts recommend that we should reserve a brain MRI for patients with atypical presentations.
Another interesting fact is that even though PRES is called “reversible,” although PRES is known as a reversible syndrome, clinical and radiological sequels have been reported in literature. A review that assessed the long-term consequences of the PRES in preeclampsia-eclampsia (PEE) found that the brain imaging features are reversible. In another study about clinical and radiological differences in PRES between individuals with PEE and other predisposing diseases, the PEE subjects had mild forms of PRES with fewer sequels when compared to the other groups. However, retrospective studies found permanent changes on brain MRI, which these lasting features probably are associated with the acute phase clinical manifestation, mainly seizures number, and primary MRI findings.
We agree with the statement of Sivaguru et al. that PRES may be completely reversible with early management, but late diagnosis may cause severe and irreversible complications.
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Conflicts of interest
There are no conflicts of interest.
| References|| |
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