Posterior reversible encephalopathy syndrome (PRES) with immune system activation, VEGF up-regulation, and cerebral amyloid angiopathy

J Comput Assist Tomogr. 2011 Jan-Feb;35(1):39-42. doi: 10.1097/RCT.0b013e3181f31917.

Abstract

The case of a 75-year-old man with a history of lymphoma, recent upper respiratory tract infection, and a protracted course of encephalopathy is presented. Radiologically, findings were consistent with posterior reversible encephalopathy syndrome. A brain biopsy revealed evidence of endothelial activation, T-cell trafficking, and vascular endothelial growth factor expression, suggesting that systemic immune system activation may be involved with triggering posterior reversible encephalopathy syndrome. In addition, underlying cerebral amyloid angiopathy may have contributed to the initial nonclassical edema distribution by compromising autoregulatory blood flow mechanisms.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Biopsy
  • Brain Diseases / diagnostic imaging*
  • Brain Diseases / immunology
  • Brain Diseases / metabolism
  • Brain Diseases / pathology
  • Brain Edema / diagnostic imaging*
  • Brain Edema / immunology
  • Brain Edema / metabolism
  • Brain Edema / pathology
  • Cerebral Amyloid Angiopathy / diagnostic imaging*
  • Cerebral Amyloid Angiopathy / immunology
  • Cerebral Amyloid Angiopathy / metabolism
  • Cerebral Amyloid Angiopathy / pathology
  • Comorbidity
  • Humans
  • Hypertensive Encephalopathy / diagnostic imaging*
  • Hypertensive Encephalopathy / immunology
  • Hypertensive Encephalopathy / metabolism
  • Hypertensive Encephalopathy / pathology
  • Male
  • Syndrome
  • Tomography, X-Ray Computed*
  • Vascular Endothelial Growth Factor A / metabolism*

Substances

  • Vascular Endothelial Growth Factor A