Related Experiment Video
Updated: Aug 16, 2026
Intravascular Perfusion of Carbon Black Ink Allows Reliable Visualization of Cerebral Vessels
Published on: January 4, 2013
CT perfusion imaging in the management of posterior reversible encephalopathy
S O Casey1, A McKinney, M Teksam
1Department of Radiology, University of Minnesota Medical School, 420 Delaware Street SE, Box 292, Minneapolis, MN 55455, USA. Casey021@tc.umn.edu
Insights
Posterior reversible encephalopathy syndrome (PRES) in a renal transplant patient was managed with antihypertensive therapy. Cerebral perfusion monitoring using stable xenon (Xe) CT guided blood pressure adjustments, resolving ischemia and potentially preventing infarction.
Area of Science:
- Nephrology
- Neurology
- Radiology
Background:
- Posterior reversible encephalopathy syndrome (PRES) is a neurological condition often associated with hypertension.
- Renal transplant recipients are at risk for hypertension and PRES due to immunosuppressive medications and underlying renal dysfunction.
Observation:
- A 13-year-old renal transplant patient presented with hypertension and seizures, diagnosed with PRES based on neuroimaging.
- Initial antihypertensive therapy led to reduced blood pressure but revealed cerebral ischemia on stable xenon (Xe) CT perfusion imaging.
- Adjusting antihypertensive medication to increase blood pressure resulted in the resolution of ischemic changes.
Findings:
- Stable xenon (Xe) CT perfusion imaging is a valuable tool for assessing cerebral blood flow in PRES.
- Titration of antihypertensive therapy guided by Xe CT perfusion imaging can effectively manage PRES and prevent cerebral infarction.
- This case highlights the importance of individualized blood pressure targets in PRES management, particularly in transplant patients.
Implications:
- Cerebral perfusion monitoring may be crucial for optimizing antihypertensive treatment in PRES patients.
- Xe CT perfusion imaging can guide therapeutic adjustments to prevent irreversible brain damage.
- This approach may improve outcomes for renal transplant recipients experiencing PRES.
Abstract:
A 13-year-old girl with a renal transplant presented with hypertension and seizures. CT and MRI demonstrated typical bilateral parietal, occipital and posterior frontal cortical and subcortical edema, thought to represent posterior reversible encephalopathy syndrome. The cause was presumed to be hypertension. Antihypertensive therapy was started, lowering of the blood pressure in the range of 110-120 mmHg systolic. However, stable xenon (Xe) CT perfusion imaging revealed ischemia within the left parietal occipital region. The antihypertensive was adjusted which increased both the systolic and diastolic blood pressure by 31 mm Hg. The patient was re-imaged with Xe CT and was found to have resolution of the ischemic changes within the left parietal occipital region. In this report, we present a case in which stable Xe CT was used to monitor the degree of cerebral perfusion and guide titration of antihypertensive therapy. Such brain perfusion monitoring may have helped to prevent infarction of our patient.
More Related Videos
09:48Quantification of Neurovascular Protection Following Repetitive Hypoxic Preconditioning and Transient Middle Cerebral Artery Occlusion in Mice
Published on: May 4, 2015
13:10Combined Near-infrared Fluorescent Imaging and Micro-computed Tomography for Directly Visualizing Cerebral Thromboemboli
Published on: September 25, 2016