Unilateral Posterior Reversible Encephalopathy Syndrome Secondary to Renal Artery Obstruction: A Case Report.
10.26815/jkcns.2018.26.2.113
- Author:
Yun Young ROH
1
;
Ji Hyung YOO
;
Hee Jung CHUNG
Author Information
1. Department of Pediatrics, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Unilateral posterior leukoencephalopathy syndrome;
Seizure;
Hypertension;
Renal artery obstruction
- MeSH:
Adolescent;
Angiography;
Autoimmune Diseases;
Blood Pressure;
Brain Edema;
Consciousness;
Eclampsia;
Edema;
Female;
Follow-Up Studies;
Gastroenteritis;
Headache;
Hospitalization;
Humans;
Hypertension;
Hypertension, Renovascular;
Immunosuppressive Agents;
Magnetic Resonance Imaging;
Male;
Neuroimaging;
Occipital Lobe;
Posterior Leukoencephalopathy Syndrome*;
Pre-Eclampsia;
Pregnancy;
Rabeprazole;
Renal Artery Obstruction*;
Renal Artery*;
Seizures;
Vomiting
- From:
Journal of the Korean Child Neurology Society
2018;26(2):113-118
- CountryRepublic of Korea
- Language:English
-
Abstract:
Posterior reversible encephalopathy syndrome (PRES, or posterior leukoencephalopahty syndrome) is a neurological condition caused by reversible cortical/subcortical vasogenic brain edema secondary to hypertension, cytotoxic drugs, immunosuppressants, autoimmune diseases, renal disease, eclampsia or pre-eclampsia. It is characterized by acute neurological symptoms such as headache, seizures, visual disturbances, and impaired levels of consciousness. Brain imaging usually reveals bilateral, cortical/subcortical vasogenic edema. Completely unilateral PRES constituted only 2.6% of the cases in a previous study. Here we report the case of a pediatric patient with completely unilateral PRES. A 13-year-old boy was admitted with acute gastroenteritis. On the fourth day of hospitalization, he started to complain of headache and vomiting. He then developed generalized tonic-clonic seizure 3 times. His blood pressure was 180/121 mmHg during the first seizure, 188/112 mmHg during the second seizure and 152/92 mmHg during the third seizure. T2-weighted imaging with fluid attenuation by inversion recovery (T2 FLAIR) demonstrated high-signal intensity in the cortical gyri of the left frontal, parietal, and occipital lobes. Follow-up magnetic resonance imaging (MRI) was performed 2 weeks after the seizure onset, which indicated a significant improvement in the patient's condition. Abdominal pelvic computed tomography (CT) and renal CT angiography showed abnormal narrowing of the left renal artery. In summary, we present a case report of unilateral PRES secondary to renovascular hypertension due to left renal arterial obstruction.
