Background: Posterior reversible encephalopathy syndrome (PRES) is an uncommon clinical-neuroradiological syndrome with an unclear pathophysiology. Correlation between PRES and the use of immunosuppressant drugs have ...Background: Posterior reversible encephalopathy syndrome (PRES) is an uncommon clinical-neuroradiological syndrome with an unclear pathophysiology. Correlation between PRES and the use of immunosuppressant drugs have previously been described, as well as correlation between elevated blood pressure and PRES. Characteristic brain MRI manifestations include hyperintense lesions on T2 and FLAIR (fluid-attenuated inversion recovery) images. PRES is usually reversible within a short period of time after discontinuation of the presumably offending drug. Some cases of PRES might complicate with intracranial hemorrhage, refractory status epilepticus or expansive vasogenic brain edema (also regarded as “tumefactive” PRES). Methods: We present a case of a young man diagnosed with Hodgkin’s lymphoma, following a laparotomy due to cecal volvulus. The patient received glucocorticoids and elevated blood pressure values were recorded. Brain imaging studies were performed due to generalized epileptic seizures, demonstrating neuroradiological findings consistent with PRES. Neurological and neuroradiological deterioration was noted, necessitating urgent neurosurgical intervention. A complete neurological and functional rehabilitation was achieved. Conclusion: The uncommon cases of complicated PRES should be taken under consideration whenever clinical deterioration is noted following the diagnosis of PRES. Early neuroradiological evaluation should be sought, together with aggressive medical and surgical treatment in cases of life threatening mass effect.展开更多
Introduction: Intraoperative cardiovascular complications were previously demonstrated in relation to high sympathetic nervous system outflow or stimulation of the vagal nerve nucleus during theneurosurgical procedure...Introduction: Intraoperative cardiovascular complications were previously demonstrated in relation to high sympathetic nervous system outflow or stimulation of the vagal nerve nucleus during theneurosurgical procedures on brain tumors. Main Symptoms and Important Clinical Findings: We are presenting clinical case of 13-year-old girl who suffered from midbrain glioma and developed life threatening cardiovascular events during neurosurgical procedure after surgicel hemostatic agent application. Therapeutic Interventions and Outcomes: Cardiovascular stability has been restored after immediate removal of surgicel from the operating field. We believe that it might be related to direct application of the surgicel hemostatic agent.展开更多
文摘Background: Posterior reversible encephalopathy syndrome (PRES) is an uncommon clinical-neuroradiological syndrome with an unclear pathophysiology. Correlation between PRES and the use of immunosuppressant drugs have previously been described, as well as correlation between elevated blood pressure and PRES. Characteristic brain MRI manifestations include hyperintense lesions on T2 and FLAIR (fluid-attenuated inversion recovery) images. PRES is usually reversible within a short period of time after discontinuation of the presumably offending drug. Some cases of PRES might complicate with intracranial hemorrhage, refractory status epilepticus or expansive vasogenic brain edema (also regarded as “tumefactive” PRES). Methods: We present a case of a young man diagnosed with Hodgkin’s lymphoma, following a laparotomy due to cecal volvulus. The patient received glucocorticoids and elevated blood pressure values were recorded. Brain imaging studies were performed due to generalized epileptic seizures, demonstrating neuroradiological findings consistent with PRES. Neurological and neuroradiological deterioration was noted, necessitating urgent neurosurgical intervention. A complete neurological and functional rehabilitation was achieved. Conclusion: The uncommon cases of complicated PRES should be taken under consideration whenever clinical deterioration is noted following the diagnosis of PRES. Early neuroradiological evaluation should be sought, together with aggressive medical and surgical treatment in cases of life threatening mass effect.
文摘Introduction: Intraoperative cardiovascular complications were previously demonstrated in relation to high sympathetic nervous system outflow or stimulation of the vagal nerve nucleus during theneurosurgical procedures on brain tumors. Main Symptoms and Important Clinical Findings: We are presenting clinical case of 13-year-old girl who suffered from midbrain glioma and developed life threatening cardiovascular events during neurosurgical procedure after surgicel hemostatic agent application. Therapeutic Interventions and Outcomes: Cardiovascular stability has been restored after immediate removal of surgicel from the operating field. We believe that it might be related to direct application of the surgicel hemostatic agent.
