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Recurrent PRES in a Patient With Cyclic Vomiting Syndrome.

Arman Mahmood1, Allen Mao1,2, Ibrahim Sacit Tuna1,3,2

  • 1University of Florida College of Medicine, Gainesville, Florida, USA, ufl.edu.

Case Reports in Radiology
|June 29, 2026
PubMed
Summary
This summary is machine-generated.

Cyclic vomiting syndrome (CVS) may be linked to posterior reversible encephalopathy syndrome (PRES) in adolescents. This case highlights recurrent hypertensive PRES in a patient with CVS, emphasizing prompt treatment and exclusion of other causes.

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Area of Science:

  • Neurology
  • Gastroenterology
  • Pediatrics

Background:

  • Cyclic vomiting syndrome (CVS) is a functional gastrointestinal disorder characterized by recurrent nausea and vomiting, often with autonomic dysregulation and hypertension.
  • Posterior reversible encephalopathy syndrome (PRES) is a neurological condition associated with acute hypertension and vasogenic edema on neuroimaging.

Purpose of the Study:

  • To describe a case of recurrent hypertensive PRES in an adolescent with a history of CVS.
  • To explore the potential link between CVS-related autonomic dysfunction and PRES.
  • To emphasize the importance of recognizing and managing hypertensive PRES in this patient population.

Main Methods:

  • Case report of a 16-year-old female with CVS and chronic hypertension.
  • Review of medical history, including prior PRES episode in 2012.
  • Neuroimaging (MRI) to confirm PRES and assess vasogenic edema.
  • Systematic exclusion of secondary causes of hypertension.

Main Results:

  • The patient experienced MRI-confirmed PRES during a period of sustained postoperative hypertension.
  • Neuroimaging showed vasogenic edema in the parieto-occipital lobes and cerebellar vermis.
  • Secondary causes of hypertension were excluded, and PRES was attributed to the patient's hypertension, potentially influenced by CVS-related autonomic dysregulation.

Conclusions:

  • Recurrent hypertensive PRES can occur in adolescents with CVS.
  • Hypertension is the primary driver of PRES, but CVS-related autonomic dysregulation may be a contributing factor.
  • Prompt antihypertensive therapy and seizure prophylaxis are crucial for managing PRES in such cases, alongside excluding other etiologies.