Recurrent posterior reversible encephalopathy syndrome with cerebellar involvement leading to acute hydrocephalus

Clin Neurol Neurosurg. 2018 Sep:172:120-123. doi: 10.1016/j.clineuro.2018.07.005. Epub 2018 Jul 5.

Abstract

Posterior reversible encephalopathy syndrome or PRES is a proposed cliniconeuroradiological entity that is characterized by headache, confusion, seizure, cortical visual disturbances or even blindness and, to a lesser extent, focal neurological signs. The etiology of this entity includes a sudden increase in blood pressure, renal failure, immunosuppressive drugs, infections, and intravenous immunoglobulin (IVIG). Classically, magnetic resonance imaging (MRI) findings show a symmetric reversible vasogenic edema in the parietooccipital lobes. PRES can involve the brainstem and cerebellum and sometimes can leave irreversible lesions but it can also recur, which is a very rare presentation. In this article, we report a case of recurrent PRES with cerebellar involvement associated with non-communicating hydrocephalus in a 2-year-old child with renal failure on peritoneal dialysis after receiving Etoposide for macrophage activation syndrome.

Keywords: Atypical hemolytic uremic syndrome; Cerebellar; Hydrocephalus; Macrophage activation syndrome; Posterior reversible encephalopathy syndrome.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Brain Stem / surgery
  • Cerebellum / pathology
  • Cerebellum / surgery*
  • Child, Preschool
  • Humans
  • Hydrocephalus / complications
  • Hydrocephalus / surgery*
  • Magnetic Resonance Imaging / adverse effects
  • Male
  • Posterior Leukoencephalopathy Syndrome / diagnosis
  • Posterior Leukoencephalopathy Syndrome / surgery*
  • Recurrence
  • Seizures / complications
  • Seizures / surgery