Which MRI findings are characteristic of posterior reversible encephalopathy syndrome (PRES) in the workup of acute stroke?

Updated: Dec 19, 2018
  • Author: Souvik Sen, MD, MPH, MS, FAHA; Chief Editor: Helmi L Lutsep, MD  more...
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Answer

Posterior reversible encephalopathy syndrome (PRES) presents clinically with acute/subacute onset headache, seizures, visual changes, altered mental status, and occasionally focal neurologic signs. MRI typically shows symmetrically distributed areas of vasogenic edema predominantly within the territories of the posterior circulation. The abnormalities affect primarily the white matter, but cortex is also involved. The diffusion weighted abnormality is associated with normal or high ADC value, differentiating the vasogenic edema induced by hypertension from cytoxic edema induced by ischemia. [6]


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