[Clinical and imaging course of posterior reversible encephalopathy syndrome in a patient with endocarditis and arterial hypertension]

Nervenarzt. 2020 Apr;91(4):343-348. doi: 10.1007/s00115-020-00877-1.
[Article in German]

Abstract

Posterior reversible encephalopathy (PRES) is a clinical syndrome characterized by headaches, seizures, cortical blindness, and altered mental status up to coma and by a radiological syndrome defined by edematous alteration on Magnetic Resonance Imaging (MRI)-Scans of the white matter. In the following, we present the case of a 73 years old post-operative patient with PRES in the context of hypertension and endocarditis with E. coli. The initial presentation included a series of seizures, sopor, and cortical blindness. In MRI-Scans a marked cerebral edema could be identified. After successful treatment of underlying conditions, the patient has made a good recovery. However, homonymous hemianopsia towards right due to laminar necrosis in the left occipital lobe remained as a residuum.

Keywords: Endocarditis with E. coli; Epileptic seizures; Laminar necrosis; Marked brain edema; PRES.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Endocarditis* / diagnostic imaging
  • Endocarditis* / etiology
  • Escherichia coli
  • Escherichia coli Infections* / complications
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Posterior Leukoencephalopathy Syndrome* / diagnostic imaging
  • Pulmonary Arterial Hypertension* / etiology
  • Treatment Outcome