PRES with asymptomatic spinal cord involvement. Is this scenario more common than we know?

Area of Science:

• Neurology
• Oncology
• Radiology

Background:

• Posterior reversible encephalopathy syndrome (PRES) is a neurological condition causing headaches, altered mental status, seizures, and visual changes.
• It is characterized by vasogenic edema in the brain's white matter, primarily in the posterior regions.

Purpose of the Study:

• To report a case of PRES in a young patient following chemotherapy for testicular teratocarcinoma.
• To discuss the rare involvement of the spinal cord in PRES.

Main Methods:

• Case report of a 19-year-old male patient.
• Review of clinical presentation, chemotherapy treatment, and blood pressure changes.
• Literature review on spinal cord involvement in PRES.

Main Results:

• The patient developed PRES subsequent to chemotherapy and elevated blood pressure.
• Spinal cord involvement in PRES is infrequently reported.
• When present, spinal cord involvement in PRES is typically asymptomatic or mildly symptomatic.

Conclusions:

• PRES can manifest with spinal cord involvement, although it is uncommon.
• The spinal cord presentation in PRES is often subtle, making early diagnosis challenging.
• This case underscores the importance of considering PRES in patients with neurological symptoms after chemotherapy and hypertension.