Posterior reversible encephalopathy syndrome (PRES), also known as acute hypertensive encephalopathy

Posterior-reversible-encephalopathy-Jan-2013.jpg

Image 1

Clinical History: 
A 25 year-old woman on chemotherapy, with hypertension and visual symptoms

Diagnosis:
Posterior reversible encephalopathy syndrome (PRES), also known as acute hypertensive encephalopathy

MR Technique: 
2D 4 mm FSE FLAIR and EPI single shot DWI axial images are presented, obtained at 3 T using a Siemens Verio MR system. Scan parameters were TR/TE/TI = 9000/120/2500 and 5300/95, with acquisition times of 2:24 and 2:15.

Imaging Findings:
Prominent areas of increased signal intensity involve the cortex and subcortical white matter of the parietal and occipital lobes bilaterally on the FLAIR scan. Similar abnormal increased signal intensity was present within the cerebellar hemispheres bilaterally (images not shown). These areas also demonstrate abnormal high signal intensity on DWI. DWI scans are usually normal in PRES, with the findings in this patient less common.