Posterior Reversible Encephalopathy Syndrome Mimicking Cerebral Metastasis: Contraindication for Biopsy
نویسندگان
چکیده
The posterior reversible encephalopathy syndrome (PRES) is a well described entity of white matter pathology. PRES is triggered by numerous different factors such as acute elevated arterial hypertension, immunosupressive therapy, chemotherapy, etc. The case of a 67-year old woman is presented. The patient was treated for breast cancer 10 months ago and because of acute disorientation a magnetic resonance imaging (MRI) was performed. In the MRI biparieto-occipital hyperintense lesions were seen. Brain metastases were suspected. After chemotherapy and hypertonia and the typical appearance of the lesions in the MRI, PRES was also suspected. Before initializing the surgery for an open biopsy a follow-up MRI had been performed (2 weeks after initial MRI). In follow-up MRI the lesions disappeared completely proving the diagnosis of PRES. PRES can be misdiagnosed as a tumour and surgery could be mistakenly performed. It's important to keep the differential diagnosis of PRES in mind when radiologic features of the syndrome are present.
منابع مشابه
Two Unusual Aspects of Posterior Reversible Encephalopathy Syndrome Mimicking Primary and Secondary Brain Tumor Lesions
The posterior reversible encephalopathy syndrome (PRES) is a rare clinical-radiological entity well described with typical clinical and radiological manifestations. Atypical presentation, especially in imaging, exists. The authors report here two cases of posterior reversible encephalopathy in which imaging aspects were atypical, mimicking, in the first case, hemorrhagic cerebral metastasis of ...
متن کاملUnexpected Maternal Convulsion: An Idiopathic Case of Posterior Reversible Encephalopathy Syndrome after Delivery
Posterior reversible encephalopathy syndrome (PRES) is associated with various clinical manifestations such as headache, blurred vision, confusion and tonic-clonic convulsion. Some of the predisposing factors for PRES include hypertensive encephalopathy, preeclampsia and eclampsia, lupus erythematosus, thrombotic thrombocytopenic purpura and long-term use of immunosuppressive drugs. This condit...
متن کاملPosterior Reversible Encephalopathy Syndrome Mimicking a Left Middle Cerebral Artery Stroke
Certain Acute Clinical presentations are highly suggestive of stroke caused by specific mechanisms. One example of this would be the sudden onset of aphasia without hemiparesis often reflecting cerebral embolism, frequently from a cardiac source. Posterior reversible encephalopathy syndrome (PRES) describes a usually reversible neurologic syndrome with a variety of presenting symptoms from head...
متن کاملAtypical Unilateral Posterior Reversible Encephalopathy Syndrome Mimicking a Middle Cerebral Artery Infarction
Posterior reversible encephalopathy syndrome (PRES) is usually a reversible clinical and radiological entity associated with typical features on brain MR or CT imaging. However, the not-so-uncommon atypical radiological presentations of the condition are also present and they may go unrecognised as they are confused with other conditions. Here, we report a very rare case of atypical, unilateral...
متن کاملHypertensive encephalopathy and cerebral infarction
INTRODUCTION Hypertensive encephalopathy is one cause of posterior reversible encephalopathy syndrome. Hypertensive encephalopathy and cerebral infarction have only been reported in a few individual case reports. CASE DESCRIPTION A 51-year-old woman presented with hypertensive encephalopathy. T2-weighted images from magnetic resonance imaging showed hyperintense lesions in both occipital and ...
متن کامل