naa a22 4500 510800017 CHVBK 20180411083351.0 cr unu---uuuuu 180411e20130201xx s 000 0 eng 10.1007/s12028-012-9798-6 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9798-6 Posterior Reversible Leukoencephalopathy Syndrome Presenting with Global Cerebral Edema and Herniation [Elektronische Daten] [Vivien Lee, Richard Temes, Sayona John, James Conners, Thomas Bleck, Shyam Prabhakaran] Background: We report a case of global cerebral edema and herniation due to Posterior Reversible Leukoencephalopathy Syndrome (PRES). Methods: Case report. Results: A 37-year-old healthy female developed persistent severe occipital headache, and after 1 month of persistent headache, developed an episode of loss of consciousness. CT brain showed diffuse cerebral edema and effacement of the sulci and basal cisterns.Her initial neurological examination was nonfocal but with severe headache. Overnight, she acutely became unresponsive with fixed dilated pupils, tachycardia, and hypertension. She was intubated and treated with hypertonic saline and mannitol with improvement in her clinical status. Intracranial Pressure (ICP) monitor showed elevated ICPs to 37 mmHg which responded to mannitol. MRI brain showed diffuse vasogenic edema predominantly in the white matter without enhancement. Cerebral angiogram was unremarkable. Cerebrospinal fluid including infectious work-up was negative. With supportive care, her mental status improved. On her 3 month follow-up visit, she was asymptomatic and had returned to work. Repeat MRI brain at 3 months showed persistent white matter changes that subsequently resolved at 9 months. Conclusions: Although PRES is typically considered to have a benign clinical course, clinician should be aware that severe cases can present with global cerebral edema and associated complications including intracranial hypertension and herniation. Springer Science+Business Media New York, 2012 Posterior Reversible Leukoencephalopathy Syndrome nationallicence Global cerebral edema nationallicence Herniation nationallicence Lee Vivien Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut Temes Richard Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut John Sayona Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut Conners James Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut Bleck Thomas Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut Prabhakaran Shyam Department of Neurology, Northwestern University, 60611, Chicago, IL, USA aut Neurocritical Care Humana Press Inc 18/1(2013-02-01), 81-83 1541-6933 18:1<81 2013 18 12028 https://doi.org/10.1007/s12028-012-9798-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9798-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Lee Vivien Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut NATIONALLICENCE 700 1- Temes Richard Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut NATIONALLICENCE 700 1- John Sayona Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut NATIONALLICENCE 700 1- Conners James Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut NATIONALLICENCE 700 1- Bleck Thomas Department of Neurological Sciences, Section of Stroke and Neurocritical Care, Rush University Medical Center, 1725W. Harrison St #1121, 60612, Chicago, IL, USA aut NATIONALLICENCE 700 1- Prabhakaran Shyam Department of Neurology, Northwestern University, 60611, Chicago, IL, USA aut NATIONALLICENCE 773 0- Neurocritical Care Humana Press Inc 18/1(2013-02-01), 81-83 1541-6933 18:1<81 2013 18 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer