Open AccessPosterior reversible encephalopathy syndrome (PRES) in a patient with moyamoya disease
Author(s) -
Chun-hsin Teng,
I-Hsiao Yang,
MengNi Wu,
Ping-Song Chou
Publication year - 2021
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000026837
Subject(s) - medicine , posterior reversible encephalopathy syndrome , moyamoya disease , magnetic resonance imaging , cerebral edema , stroke (engine) , cerebral infarction , neuroimaging , cerebral blood flow , pathophysiology , hypertensive encephalopathy , cardiology , blood pressure , anesthesia , ischemia , radiology , psychiatry , mechanical engineering , engineering
Abstract Introduction: Moyamoya disease (MMD) and posterior reversible encephalopathy syndrome (PRES) share similar pathophysiological characteristics of endothelial dysfunction and impaired cerebral autoregulation. However, there have never been any published studies to demonstrate the relationship between these 2 rare diseases. Patient concerns: A 26-year-old Asian man presented with a throbbing headache, blurred vision, and extremely high blood pressure. We initially suspected acute cerebral infarction based on the cerebral computed tomography, underlying MMD, and prior ischemic stroke. However, the neurological symptoms deteriorated progressively. Diagnosis: Cerebral magnetic resonance imaging indicated the presence of vasogenic edema rather than cerebral infarction. Interventions and outcomes: An appropriate blood pressure management prevents the patient from disastrous outcomes successfully. Cerebral magnetic resonance imaging at 2 months post treatment disclosed the complete resolution of cerebral edema. The patient's recovery from clinical symptoms and the neuroimaging changes supported the PRES diagnosis. Conclusion: This report suggests that patients with MMD may be susceptible to PRES. It highlights the importance of considering PRES as a differential diagnosis while providing care to MMD patients with concurrent acute neurological symptoms and a prompt intervention contributes to a favorable clinical prognosis.