Published in:
01-07-2017 | Case Report - Vascular
Life-threatening posterior reversible encephalopathy syndrome in the cerebellum treated by posterior fossa decompression
Authors:
Yousef Abusabha, Athanasios K. Petridis, Bastian Kraus, Marcel A. Kamp, Hans-Jakob Steiger, Kerim Beseoglu
Published in:
Acta Neurochirurgica
|
Issue 7/2017
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Abstract
Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological syndrome associated with various clinical conditions, such as headache, encephalopathy, and seizures. It is reversible if a prompt diagnosis is made and treatment undertaken. We report a 52-year-old male with hypertensive crisis. Progressing somnolence and an unresponsive left pupil occurred. MRI revealed an intra-axial hyperintensity of the cerebellum and brainstem and occlusive hydrocephalus suggestive of encephalitis or a tumor. Because of the life-threatening clinical picture, posterior fossa decompression was performed. Histopathology failed to identify any pathology. After decompression, the edema improved immediately. Under life-threatening conditions, a decompressive craniectomy in PRES seems to achieve the same results as supportive treatment.