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Hypertensive posterior reversible encephalopathy causing obstructive hydrocephalus.

Saad Moughal1, Sana Ahmad2, Nayyar Saleem1

  • 1Department of Neuroradiology, Leeds Teaching Hospitals NHS Trust, Leeds.

Surgical Neurology International
|April 7, 2023
PubMed
Summary

Posterior reversible encephalopathy syndrome (PRES) rarely affects only the infratentorial structures. Aggressive blood pressure control led to a good outcome in a case of PRES with isolated infratentorial involvement.

Keywords:
Cerebral autoregulationHypertensive encephalopathyObstructive hydrocephalusPosterior fossa oedema

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Area of Science:

  • Neurology
  • Radiology

Background:

  • Posterior reversible encephalopathy syndrome (PRES) is typically associated with malignant hypertension impacting cerebral autoregulation.
  • While supratentorial involvement is common, PRES predominantly affecting infratentorial structures is rare.

Observation:

  • This case report details a rare instance of PRES with isolated infratentorial involvement.
  • The condition led to obstructive hydrocephalus, presenting a unique clinical challenge.

Findings:

  • The patient presented with symptoms suggestive of PRES affecting the posterior fossa.
  • Isolated infratentorial PRES was confirmed, complicated by obstructive hydrocephalus.

Implications:

  • This case highlights the importance of considering PRES even with atypical infratentorial presentations.
  • Effective management through aggressive blood pressure control, without surgical intervention, resulted in a positive patient outcome.