Hypertensive posterior reversible encephalopathy syndrome causing posterior fossa edema and hydrocephalus

Andrew J Grossbach; Taylor J Abel; Brendan Hodis; Shafik N Wassef; Jeremy D W Greenlee

doi:10.1016/j.jocn.2013.07.005

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Hypertensive posterior reversible encephalopathy syndrome causing posterior fossa edema and hydrocephalus

Journal article

Peer reviewed

Hypertensive posterior reversible encephalopathy syndrome causing posterior fossa edema and hydrocephalus

Andrew J Grossbach, Taylor J Abel, Brendan Hodis, Shafik N Wassef and Jeremy D W Greenlee

Journal of clinical neuroscience, Vol.21(2), pp.207-211

02/2014

DOI: 10.1016/j.jocn.2013.07.005

PMID: 24126039

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Abstract

Posterior reversible encephalopathy syndrome (PRES) is a well characterized entity resulting from the inability of cerebral autoregulation to adequately protect the brain from uncontrolled hypertension. It primarily affects the occipital lobes, but can also involve the structures in the posterior fossa including the brainstem and cerebellum. Treatment usually consists of strict blood pressure control, but more aggressive management may be indicated with acutely worsening neurological status. We present a patient with hypertensive encephalopathy that resulted in hydrocephalus and brainstem compression necessitating surgical decompression requiring ventriculostomy and suboccipital craniectomy. In rare cases, PRES can present with severe brainstem compression requiring emergent posterior fossa decompression. When brainstem signs are present on exam, emergent posterior fossa decompression may be safer than ventriculostomy alone.

Brain Edema - etiology

Brain Edema - pathology

Humans

Hydrocephalus - etiology

Hydrocephalus - pathology

Tomography, X-Ray Computed

Treatment Outcome

Posterior Leukoencephalopathy Syndrome - surgery

Cerebellum - pathology

Magnetic Resonance Imaging

Brain Edema - surgery

Brain Stem - pathology

Hydrocephalus - surgery

Cerebellum - surgery

Posterior Leukoencephalopathy Syndrome - complications

Brain - pathology

Brain - surgery

Female

Posterior Leukoencephalopathy Syndrome - diagnostic imaging

Aged

Brain Stem - surgery

Details

Title: Subtitle: Hypertensive posterior reversible encephalopathy syndrome causing posterior fossa edema and hydrocephalus
Creators: Andrew J Grossbach - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52245, USA. Electronic address: Andrew-grossbach@uiowa.edu
Taylor J Abel - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52245, USA
Brendan Hodis - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52245, USA
Shafik N Wassef - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52245, USA
Jeremy D W Greenlee - Department of Neurosurgery, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52245, USA
Resource Type: Journal article
Publication Details: Journal of clinical neuroscience, Vol.21(2), pp.207-211
Publisher: Scotland
DOI: 10.1016/j.jocn.2013.07.005
PMID: 24126039
ISSN: 0967-5868
eISSN: 1532-2653
Language: English
Date published: 02/2014
Academic Unit: Stead Family Department of Pediatrics; Iowa Neuroscience Institute; Neurosurgery; Otolaryngology
Record Identifier: 9984040397502771

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