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Severe posterior reversible encephalopathy syndrome resolved with craniectomy
Yoshinobu Nagaoka1, Kenji Ishikura, Riku Hamada
1Department of Nephrology, Tokyo Metropolitan Children's Medical Center, Tokyo, Japan.
Summary
Posterior reversible encephalopathy syndrome (PRES) can be severe. This case highlights emergency decompressive craniectomy and blood pressure control as crucial for recovery in critical PRES cases.
Area of Science:
- Neurology
- Nephrology
- Pediatrics
Background:
- Posterior reversible encephalopathy syndrome (PRES) is increasingly recognized as potentially severe.
- Congenital nephrotic syndrome is a risk factor for PRES.
Observation:
- A 3-year-old girl with congenital nephrotic syndrome rapidly progressed to coma.
- Head CT revealed brainstem swelling and transtentorial herniation.
Findings:
- Emergency decompressive craniectomy and optimal blood pressure management were performed.
- The patient showed rapid clinical improvement and CT finding resolution, confirming PRES.
- Surgical intervention is vital for severe PRES with unstable vital signs.
Implications:
- This case underscores the importance of considering surgical intervention in severe PRES.
- Aggressive blood pressure management is critical for favorable outcomes in PRES.
- Early recognition and intervention can improve prognosis in pediatric PRES.
Keywords:
brainstemcerebellar herniationdecompressive craniectomyreversible posterior leukoencephalopathy syndromeMore Related Videos
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