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A Case of Chronic Renal Failure and Recurrent Posterior Reversible Encephalopathy Syndrome

Author(s): Ayşe | Macit | Ülkü | Gür | Hüsnü | Sezer Şener

Journal: Nöropsikiyatri Arşivi
ISSN 1300-0667

Volume: 46;
Issue: 4;
Start page: 270;
Date: 2011;
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Keywords: Renal failure | recurrent PRES | vasogenic edema

Posterior reversible encephalopathy syndrome (PRES) is a rare clinical and radiological entity of neurological origin which has different etiologies. A 27-year-old male patient with a history of type 1 diabetes, uncontrolled hypertension and chronic renal failure presented to the emergency department with complaints of confusion, high blood pressure and seizures. Magnetic resonance imaging (MRI) revealed bilateral hyperintense lesions in the occipital lobes with vasogenic edema. The lesions had disappeared at follow-up MRI. Two months after the onset, the patient presented with atypical headache and high blood pressure and, the MRI showed new, multiple hyperintense lesions in the parieto-occipital region. The diagnosis of recurrent PRES was considered based on the onset of symptoms and MRI findings. There were only 5 cases of recurrent PRES reported in the literature and only one with chronic renal disease. The hallmark of PRES is vasogenic edema in the territories of the posterior circulation. provides powerful means to establish the diagnosis and gives prognostic information about the follow-up of the patient. These patients should be carefully monitored, and the physician should be alert for possible recurrence. (Arc­hi­ves of Neu­ropsy­chi­atry 2011;48: 270-3)
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