Comments on "Unilateral Reversible Posterior Leukoencephalopathy Syndrome after Coiling of an Aneurysm"
نویسنده
چکیده
BACKGROUND Reversible posterior leukoencephalopathy syndrome (RPLS) is radiologically characterized by symmetrical subcortical areas of vasogenic edema that are preferentially parieto-occipital, and it typically resolves after appropriate treatment. CASE REPORT We present a patient with strikingly unilateral RPLS that developed 21 days after coiling of an anterior communicating artery aneurysm and several days of triple-H therapy. Cortical and subcortical vasogenic edema and enhancement developed only in the left hemisphere, with a pattern suggesting RPLS. After 7 months the lesions had nearly completely resolved. CONCLUSIONS The pathophysiological mechanism underlying RPLS is still not well understood, which makes it difficult to explain the unilateral appearance in this case. Since the imaging findings may be confused with other conditions such as ischemia, recognition of RPLS after coiling is necessary in order to avoid inadequate treatment.
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RE: Comments on "Unilateral Reversible Posterior Leukoencephalopathy Syndrome after Coiling of an Aneurysm": The Authors Respond
We would like to thank Dr. Caplan for his useful comments.1 The abnormalities in our patients are indeed quite similar to the abnormalities found in some migraine patients, as shown to us by Dr. Caplan. Our patient, however, did not have a history of migraine, nor has she developed migraine since the episode described in our case-report.2 Our posterior reversible encephalopathy syndrome/reversi...
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