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Resolved PRES

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On the left,

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you have a study from September 4, 2018,

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in a patient who had hepatorenal syndrome.

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And what one sees on the images is

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the abnormal signal intensity.

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It's somewhat hazy in its appearance,

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affecting the posterior temporal lobe and the

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occipital lobes and the parietal lobes.

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Let's just highlight that with our magic pen here.

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So this is what I'm referring to,

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is that sort of hazy,

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bright signal intensity that's extending to the

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subcortical white matter fibers,

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associated with bilateral involvement

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of the parietal lobes.

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However,

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this includes the involvement of the occipital

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lobes as we scroll further inferiorly,

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which is again demonstrated to extend all the

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way to the periphery here of the white

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matter of both occipital lobes.

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This is the September 4 study.

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On the right-hand side is the same patient,

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and the study is from October 5th.

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So, basically,

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four and a half to five weeks later.

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And as you can see,

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there is complete resolution of the involvement

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of the occipital lobes,

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as well as the parietal lobes, with no residual,

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no encephalomalacia,

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ventricle size, the same.

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Looks like it's back to normal.

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And that is the typical course that we see with

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posterior reversible encephalopathy syndrome,

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as well as the reversible cerebral

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vasoconstrictive syndrome.

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So, this is the expected and hoped-for resolution

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of PRES over the course of weeks,

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once the underlying etiology for

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PRES has been reversed.

Report

Description

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Tags

Vascular

Neuroradiology

MRI

Brain

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