Reversibility of cytotoxic edema in tacrolimus leukoencephalopathy

Posterior reversible encephalopathy syndrome, a serious neurotoxicity, may develop rarely in patients receiving tacrolimus. Because the underlying etiology of posterior reversible encephalopathy syndrome is vasogenic edema, it is generally accepted to be a reversible neurologic condition. Cranial magnetic resonance imaging techniques enable detection of the type of edema, and they are widely used in the differential diagnosis and prognostic prediction of posterior reversible encephalopathy syndrome. Presented here is a case of posterior reversible encephalopathy syndrome in which the patient recovered completely, despite radiologic findings indicating the coexistence of vasogenic and cytotoxic edema secondary to tacrolimus therapy after liver transplantation.