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Delayed CSF enhancement in posterior reversible encephalopathy syndrome
1Department of Diagnostic Radiology, Oregon Health & Science University, Portland, OR 97239, USA. hamiltob@ohsu.edu
AJNR. American Journal of Neuroradiology
|January 11, 2008
Summary
Posterior reversible encephalopathy syndrome (PRES) can show increased MRI signal in subarachnoid spaces. This finding in hypertensive encephalopathy is linked to gadolinium enhancement from increased microvascular permeability.
Area of Science:
- Neurology
- Radiology
- Neuroimaging
Background:
- Posterior Reversible Encephalopathy Syndrome (PRES) is a neurological condition often associated with acute hypertensive encephalopathy.
- Understanding the neuroimaging characteristics of PRES is crucial for accurate diagnosis and management.
Observation:
- A case study involving a patient with PRES and acute hypertensive encephalopathy was analyzed.
- Specific attention was given to Magnetic Resonance Imaging (MRI) findings, particularly on fluid-attenuated inversion recovery (FLAIR) sequences.
Findings:
- Increased signal intensity was observed in the subarachnoid spaces on 6-hour delayed enhanced MRI.
- This hyperintensity is attributed to cerebrospinal fluid (CSF) gadolinium enhancement.
- The finding aligns with the suspected pathogenesis of PRES, involving increased microvascular permeability.
Implications:
- This observation provides valuable insights into the imaging manifestations of PRES.
- It highlights the potential for detecting microvascular changes through delayed contrast enhancement in specific neuroimaging sequences.
- The findings may aid in the diagnostic process for PRES, especially in the context of hypertensive emergencies.
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