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Isolated pontine involvement of posterior reversible encephalopathy syndrome with concomitant ischemic cerebral infarction
Author(s) -
Watanabe Yuji,
Suzuki Keisuke,
Takekawa Hidehiro,
Numao Ayaka,
Asakawa Yohei,
Fujita Hiroaki,
Nakamura Toshiki,
Okamura Madoka,
Hirata Koichi
Publication year - 2015
Publication title -
neurology and clinical neuroscience
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.125
0ISSN - 2049-4173
DOI - 10.1111/ncn3.12012
Subject(s) - medicine , posterior reversible encephalopathy syndrome , brainstem , corona radiata (embryology) , pons , concomitant , magnetic resonance imaging , encephalopathy , cerebral infarction , stroke (engine) , cardiology , anesthesia , pathology , ischemia , radiology , mechanical engineering , ovarian follicle , hormone , cumulus oophorus , engineering
In posterior reversible encephalopathy syndrome, isolated involvement of the brainstem is rare. In addition, there have been a few reports describing a concomitant occurrence of stroke and a brainstem variant of posterior reversible encephalopathy syndrome. We here report a patient with isolated pontine involvement of posterior reversible encephalopathy syndrome accompanied by fresh ischemic cerebral infarction in the left corona radiata detected by brain magnetic resonance imaging. Follow‐up brain magnetic resonance imaging on hospital day 14 showed a marked improvement of signal changes in the pons; however, cerebral infarction in the left corona radiata enlarged despite medical treatment. Although rare, clinicians should be aware of the co‐occurrence of posterior reversible encephalopathy syndrome and ischemic infarctions, especially in patients with untreated/uncontrolled hypertension and chronic kidney disease. We discuss the possible mechanism related to brainstem posterior reversible encephalopathy syndrome and stroke, reviewing the previous case reports.