Revista de Neurología Clínica y Neurocirugía

Neurologic Syndromes in Post-partum Women: Posterior Reversible Encephalopathy Syndrome (PRES) vs. Reversible Cerebral Vasoconstriction Syndrome (RCVS), 2 Sides of One Coin?

Abstract

Krishnendu Choudhury1* and Sitansu Sekhar Nandi2

Posterior Reversible Encephalopathy Syndrome (PRES) and Reversible Cerebral Vasoconstriction Syndrome (RCVS) constitute a spectrum of disorders characterized by acute-onset headache, altered sensorium, hypertension, visual field defect and seizures, with radiological features of vasogenic edema particularly in parieto-occipital regions of brain. In PRES, the typical feature is vasogenic cerebral edema which is mostly reversible, while in RCVS, cytotoxic edema may persue resulting from multifocal vasoconstriction, which is also reversible with treatment producing complete recovery. Important causes of PRES are: Hypertension secondary to Preeclampsia/Eclampsia, Infections with or without CNS involvement, may be bacterial or viral, occasionally Herpes simplex encephalitis. Autoimmune disease/SLE. Here we report a woman without history of pregnancy induced hypertension who developed progressive hypertension early post- partum and presented with features of both PRES and RCVS. Early recognition of her illness with clinical and radiological features followed by appropriate treatment led to prompt response and prevented a potential threat to her life.