BACKGROUND Posterior reversible encephalopathy syndrome(PRES)is characterized mainly by occipital and parietal lobe involvement,which can be reversible within a few days.Herein,we report a rare case of PRES that devel...BACKGROUND Posterior reversible encephalopathy syndrome(PRES)is characterized mainly by occipital and parietal lobe involvement,which can be reversible within a few days.Herein,we report a rare case of PRES that developed after craniotomy for an unruptured intracranial aneurysm(UIA).CASE SUMMARY A 59-year-old man underwent clipping surgery for the treatment of UIA arising from the left middle cerebral artery.Clipping surgery was performed uneventfully,and he regained consciousness quickly immediately after the surgery.At the 4th hour after surgery,he developed a disorder of consciousness and aphasia.Magnetic resonance imaging revealed cortical and subcortical T2/FLAIR hyperintensities in the parietal,occipital,and frontal lobes ipsilaterally,without restricted diffusion,consistent with unilateral PRES.With conservative treatment,his symptoms and radiological findings almost completely disappeared within weeks.In our case,the important causative factor of PRES was suspected to be a sudden increase in cerebral perfusion pressure associated with temporary M1 occlusion.CONCLUSION Our unique case highlights that,to our knowledge,this is the second report of PRES developing after craniotomy for the treatment of UIA.Surgeons must keep PRES in mind as one of the causes of perioperative neurological abnormality following clipping of an UIA.展开更多
Posterior reversible encephalopathy syndrome (PRES), a rare disease is characterized by multiple neurological complications. It has been reported to be associated with the use of angiogenesis inhibitors such as sorafe...Posterior reversible encephalopathy syndrome (PRES), a rare disease is characterized by multiple neurological complications. It has been reported to be associated with the use of angiogenesis inhibitors such as sorafenib, sunitinib, pazopanib, regorafenib, and lenvatinib. We reported a case of 76-year-old woman with history of stage III hepatocellular carcinoma (HCC), who developed adverse drug reactions related to pazopanib induced PRES. Pazopanib, an angiogenesis inhibitor which inhibits the vascular endothelial growth factor (VEGF) pathway may lead to vascular endothelial damage, and these pathophysiological changes may lead to vascular leaks and brain edema. Medical staff must be aware of the possible association between angiogenesis inhibitors and the development of PRES. In patients with retroperitoneal soft-tissue sarcoma undergoing treatment with pazopanib, regular monitoring of their blood pressure and following-up brain magnetic resonance imaging (MRI) should be encouraged.展开更多
基金Supported by Clinical Research Grant from Pusan National University Hospital in 2022.
文摘BACKGROUND Posterior reversible encephalopathy syndrome(PRES)is characterized mainly by occipital and parietal lobe involvement,which can be reversible within a few days.Herein,we report a rare case of PRES that developed after craniotomy for an unruptured intracranial aneurysm(UIA).CASE SUMMARY A 59-year-old man underwent clipping surgery for the treatment of UIA arising from the left middle cerebral artery.Clipping surgery was performed uneventfully,and he regained consciousness quickly immediately after the surgery.At the 4th hour after surgery,he developed a disorder of consciousness and aphasia.Magnetic resonance imaging revealed cortical and subcortical T2/FLAIR hyperintensities in the parietal,occipital,and frontal lobes ipsilaterally,without restricted diffusion,consistent with unilateral PRES.With conservative treatment,his symptoms and radiological findings almost completely disappeared within weeks.In our case,the important causative factor of PRES was suspected to be a sudden increase in cerebral perfusion pressure associated with temporary M1 occlusion.CONCLUSION Our unique case highlights that,to our knowledge,this is the second report of PRES developing after craniotomy for the treatment of UIA.Surgeons must keep PRES in mind as one of the causes of perioperative neurological abnormality following clipping of an UIA.
文摘Posterior reversible encephalopathy syndrome (PRES), a rare disease is characterized by multiple neurological complications. It has been reported to be associated with the use of angiogenesis inhibitors such as sorafenib, sunitinib, pazopanib, regorafenib, and lenvatinib. We reported a case of 76-year-old woman with history of stage III hepatocellular carcinoma (HCC), who developed adverse drug reactions related to pazopanib induced PRES. Pazopanib, an angiogenesis inhibitor which inhibits the vascular endothelial growth factor (VEGF) pathway may lead to vascular endothelial damage, and these pathophysiological changes may lead to vascular leaks and brain edema. Medical staff must be aware of the possible association between angiogenesis inhibitors and the development of PRES. In patients with retroperitoneal soft-tissue sarcoma undergoing treatment with pazopanib, regular monitoring of their blood pressure and following-up brain magnetic resonance imaging (MRI) should be encouraged.
