Posterior Reversible Leukoencephalopathy Syndrome (PRES) in Intensive Care Unit - Case series.

Area of Science:

• Neurology
• Critical Care Medicine

Background:

• Posterior reversible encephalopathy syndrome (PRES) presents with diverse clinical and neuroimaging findings, often linked to hypertension.
• While typically reversible, some PRES patients experience lasting neurological deficits.
• Severe PRES cases may necessitate Intensive Care Unit (ICU) admission due to coma or status epilepticus.

Purpose of the Study:

• To analyze the characteristics and outcomes of PRES patients admitted to the ICU.
• To identify common etiologies and presenting symptoms of severe PRES.
• To evaluate the long-term neurological damage in PRES patients.

Main Methods:

• Retrospective analysis of ten adult patients diagnosed with PRES and admitted to a tertiary care ICU over five years.
• Data collected included various etiologies, reasons for ICU admission, and patient outcomes at discharge and 90 days post-admission.
• Assessment of neurological status and need for mechanical ventilation.

Main Results:

• Medications were the most frequent cause of PRES.
• Primary reasons for ICU admission included uncontrolled hypertension, seizures, and altered consciousness.
• All but one patient required mechanical ventilation, and four patients sustained residual neurological damage.

Conclusions:

• Prompt control of hypertension and elimination of precipitating factors are vital for reducing morbidity and mortality in PRES.
• Enhanced awareness and early recognition of PRES among intensivists are essential for timely and effective treatment.
• This case series highlights the severity of PRES requiring ICU care and the importance of prompt management.