72
Views
9
CrossRef citations to date
0
Altmetric
Clinical Features

Posterior Reversible Encephalopathy Syndrome: Clinicoradiological Spectrum and Therapeutic Strategies

, MD, PhD, , RN & , MD
Pages 202-213 | Published online: 13 Mar 2015

References

  • . Hinchey J, Chaves C, Appignani B, . A reversible posterior leukoencephalopathy syndrome. N Engl. J Med. 1996;334(8):494–500
  • . Pavlakis SG, Frank Y, Kalina P, Chandra M, Lu D. Occipital-parietal encephalopathy: a new name for an old syndrome. Pediatr Neurol. 1997;16(2):145–148
  • . Lanzino G, Cloft H, Hemstreet MK, West K, Alston S, Ishitani M. Reversible posterior leukoencephalopathy following organ transplantation. Description of two cases. Clin Neurol Neurosurg. 1997;99(3):222–226
  • . Casey SO, Sampaio RC, Michel E, Truwit CL. Posterior reversible encephalopathy syndrome: utility of fluid-attenuated inversion recovery MR imaging in the detection of cortical and subcortical lesions. AJNR Am J Neuroradiol. 2000;21(7):1199–1206
  • . McKinney AM, Short J, Truwit CL, . Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol. 2007;189(4):904–912
  • . Feske SK. Posterior reversible encephalopathy syndrome: a review. Semin Neurol. 2011;31(2):202–215
  • . Kwon S, Koo J, Lee S. Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Pediatr Neurol. 2001;24(5):361–364
  • . Lee VH, Wijdicks EF, Manno EM, Rabinstein AA. Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Arch Neurol. 2008;65(2):205–210
  • . Fugate JE, Claassen DO, Cloft HJ, Kallmes DF, Kozak OS, Rabinstein AA. Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. Mayo Clin Proc. 2010;85(5):427–432
  • . Liman TG, Bohner G, Heuschmann PU, Endres M, Siebert E. The clinical and radiological spectrum of posterior reversible encephalopathy syndrome: the retrospective Berlin PRES study [published online ahead of print June 30, 2011]. J Neurol.
  • . Li Y, Gor D, Walicki D, . Spectrum and potential pathogenesis of reversible posterior leukoencephalopathy syndrome [published online ahead of print June 22, 2011]. J Stroke Cerebrovasc Dis.
  • . Gümüş H, Per H, Kumandaş S, Yikilmaz A. Reversible posterior leukoencephalopathy syndrome in childhood: report of nine cases and review of the literature. Neurol Sci. 2010;31(2):125–131
  • . Roth C, Ferbert A. Posterior reversible encephalopathy syndrome: long-term follow-up. J Neurol Neurosurg Psychiatry. 2010;81(7):773–777
  • . Solinas C, Briellmann RS, Harvey AS, Mitchell LA, Berkovic SF. Hypertensive encephalopathy: antecedent to hippocampal sclerosis and temporal lobe epilepsy? Neurology. 2003;60(9):1534–1536
  • . Bakshi R Bates VE, Mechtler LL, Kinkel PR Kinkel WR. Occipital lobe seizures as the major clinical manifestation of reversible posterior leukoencephalopathy syndrome: magnetic resonance imaging findings. Epilepsia. 1998;39(3):295–299
  • . Apollon KM, Robinson JN, Schwartz RB, Norwitz ER. Cortical blindness in severe preeclampsia: computed tomography, magnetic resonance imaging, and single-photon-emission computed tomography findings. Obstet Gynecol. 2000;95(6 pt 2):1017–1019
  • . Besirli CG, Sudhakar P, Wesolowski J, Trobe JD. Serous retinal detachment in hypertensive posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol. 2011;32(11):E203–E205
  • . Bartynski WS. Posterior reversible encephalopathy syndrome, part 1: fundamental imaging and clinical features. AJNR Am J Neuroradiol. 2008;29(6):1036–1042
  • . Bartynski WS, Boardman JF. Distinct imaging patterns and lesion distribution in posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol. 2007;28(7):1320–1327
  • . Thaipisuttikul I, Phanthumchinda K. Recurrent reversible posterior leukoencephalopathy in a patient with systemic lupus erythematosus. J Neurol. 2005;252(2):230–231
  • . Dekker GA, Sibai BM. Etiology and pathogenesis of preeclampsia: current concepts. Am J Obstet Gynecol. 1998;179(5):1359–1375
  • . Schwartz RB, Feske SK, Polak JF, . Preeclampsia-eclampsia: clinical and neuroradiographic correlates and insights into the pathogenesis of hypertensive encephalopathy. Radiology. 2000;217(2):371–376
  • . Bartynski WS, Boardman JF, Zeigler ZR, Shadduck RK, Lister J. Posterior reversible encephalopathy syndrome in infection, sepsis, and shock. AJNR Am J Neuroradiol. 2006;27(10):2179–2190
  • . de Seze J, Mastain B, Stojkovic T, . Unusual MR findings of the brain stem in arterial hypertension. AJNR Am J Neuroradiol. 2000;21(2):391–394
  • . Ono Y, Manabe Y, Hamakawa Y, . Localized lesions on MRI in a case of hypertensive brainstem encephalopathy. Intern Med. 2005;44(9):1002–1005
  • . Schiff D, Lopes MB. Neuropathological correlates of reversible posterior leukoencephalopathy. Neurocrit Care. 2005;2(3):303–305
  • . Min L, Zwerling J, Ocava LC, Chen IH, Putterman C. Reversible posterior leukoencephalopathy in connective tissue diseases. Semin Arthritis Rheum. 2006;35(6):388–395
  • . Bink A, Weidauer S, Hermans M, Kell C, Lanfermann H. Reversible bilateral pyramidal tract lesions after hypertensive crisis and cerebral seizures. J Neuroradiol. 2007;34(5):340–343
  • . Doelken M, Lanz S, Rennert J, Alibek S, Richter G, Doerfler A. Differentiation of cytotoxic and vasogenic edema in a patient with reversible posterior leukoencephalopathy syndrome using diffusion-weighted MRI. Diagn Interv Radiol. 2007;13(3):125–128
  • . Hamilton BE, Nesbit GM. Delayed CSF enhancement in posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol. 2008;29(3):456–457
  • . Wennberg RA. Clinical and MRI evidence that occipital lobe seizures can be the major manifestation of the reversible posterior leukoencephalopathy syndrome (RPLS). Epilepsia. 1998;39(12):1381–1383
  • . Covarrubias DJ, Luetmer PH, Campeau NG. Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusion-weighted MR images. AJNR Am J Neuroradiol. 2002;23(6):1038–1048
  • . Sundgren PC, Edvardsson B, Holtås S. Serial investigation of perfusion disturbances and vasogenic oedema in hypertensive encephalopathy by diffusion and perfusion weighted imaging. Neuroradiology. 2002;44(4):299–304
  • . Bartynski WS, Zeigler Z, Spearman MP, Lin L, Shadduck RK, Lister J. Etiology of cortical and white matter lesions in cyclosporin-A and FK-506 neurotoxicity. AJNR Am J Neuroradiol. 2001;22(10):1901–1914
  • . Koch S, Rabinstein A, Falcone S, Forteza A. Diffusion-weighted imaging shows cytotoxic and vasogenic edema in eclampsia. AJNR Am J Neuroradiol. 2001;22(6):1068–1070
  • . Tamaki K, Sadoshima S, Baumbach GL, Iadecola C, Reis DJ, Heistad DD. Evidence that disruption of the blood-brain barrier precedes reduction in cerebral blood flow in hypertensive encephalopathy. Hypertension. 1984;6(2 pt 2):I75–I81
  • . Casey SO, McKinney A, Teksam M, Liu H, Truwit CL. CT perfusion imaging in the management of posterior reversible encephalopathy. Neuroradiology. 2004;46(4):272–276
  • . Benziada-Boudour A, Schmitt E, Kremer S, . Posterior reversible encephalopathy syndrome: a case of unusual diffusion-weighted MR images. J Neuroradiol. 2009;36(2):102–105
  • . Ozkan A, Hakyemez B, Ozkalemkas F, . Tumor lysis syndrome as a contributory factor to the development of reversible posterior leukoencephalopathy. Neuroradiology. 2006;48(12):887–892
  • . Ay H, Buonanno FS, Schaefer PW, . Posterior leukoencephalopathy without severe hypertension: utility of diffusion-weighted MRI. Neurology. 1998;51(5):1369–1376
  • . Hefzy HM, Bartynski WS, Boardman JF, Lacomis D. Hemorrhage in posterior reversible encephalopathy syndrome: imaging and clinical features. AJNR Am J Neuroradiol. 2009;30(7):1371–1379
  • . Weingarten K, Barbut D, Filippi C, Zimmerman RD. Acute hypertensive encephalopathy: findings on spin-echo and gradient-echo MR imaging. AJR Am J Roentgenol. 1994;162(3):665–670
  • . Doss-Esper CE, Singhal AB, Smith MS, Henderson GV. Reversible posterior leukoencephalopathy, cerebral vasoconstriction, and strokes after intravenous immune globulin therapy in Guillain-Barre syndrome. J Neuroimaging. 2005;15(2):188–192
  • . Peng WX, Nakaii M, Matsushima T, Asakura H. Atypical case of reversible posterior leucoencephalopathy syndrome associated with puerperal HELLP syndrome. Arch Gynecol Obstet. 2008;278(3):269–271
  • . Nakano H, Tomita Y, Bandoh K, Miyaoka M. Malignant hypertension associated with obstructive hydrocephalus—case report. Neurol Med Chir (Tokyo). 1997;37(3):265–269
  • . Wang MC, Escott EJ, Breeze RE. Posterior fossa swelling and hydrocephalus resulting from hypertensive encephalopathy: case report and review of the literature. Neurosurgery. 1999;44(6):1325–1327
  • . Chang GY, Keane JR. Hypertensive brainstem encephalopathy: three cases presenting with severe brainstem edema. Neurology. 1999;53(3):652–654
  • . Kumai Y, Toyoda K, Fujii K, Ibayashi S. Hypertensive encephalopathy extending into the whole brainstem and deep structures. Hypertens Res. 2002;25(5):797–800
  • . Kitaguchi H, Tomimoto H, Miki Y, . A brainstem variant of reversible posterior leukoencephalopathy syndrome. Neuroradiology. 2005;47(9):652–656
  • . Lim MH, Kim DW, Cho HS, . Isolated cerebellar reversible leukoencephalopathy syndrome in a patient with end stage renal disease. Intern Med. 2008;47(1):43–45
  • . Briganti C, Caulo M, Notturno F, Tartaro A, Uncini A. Asymptomatic spinal cord involvement in posterior reversible encephalopathy syndrome. Neurology. 2009;73(18):1507–1508
  • . Lapuyade B, Sibon I, Jeanin S, Dousset V. Neurological picture. Spinal cord involvement in posterior reversible encephalopathy syndrome. J Neurol Neurosurg Psychiatry. 2009;80(1):35
  • . Choh NA, Jehangir M, Rasheed M, Mira T, Ahmad I, Choh S. Involvement of the cervical cord and medulla in posterior reversible encephalopathy syndrome. Ann Saudi Med. 2011;31(1):90–92
  • . Sengar AR, Gupta RK, Dhanuka AK, Roy R, Das K. MR imaging, MR angiography, and MR spectroscopy of the brain in eclampsia. AJNR Am J Neuroradiol. 1997;18(8):1485–1490
  • . Eichler FS, Wang P, Wityk RJ, Beauchamp NJ Jr, Barker PB. Diffuse metabolic abnormalities in reversible posterior leukoencephalopathy syndrome. AJNR Am J Neuroradiol. 2002;23(5):833–837
  • . Schwartz RB, Jones KM, Kalina P, . Hypertensive encephalopathy: findings on CT, MR imaging, and SPECT imaging in 14 cases. AJR Am J Roentgenol. 1992;159(2):379–383
  • . Naidu K, Moodley J, Corr P, Hoffmann M. Single photon emission and cerebral computerised tomographic scan and transcranial Doppler sonographic findings in eclampsia. Br J Obstet Gynaecol. 1997;104(10):1165–1172
  • . Engelter ST, Petrella JR Alberts MJ, Provenzale JM. Assessment of cerebral microcirculation in a patient with hypertensive encephalopathy using MR perfusion imaging. AJR Am J Roentgenol. 1999;173(6):1491–1493
  • . Brubaker LM, Smith JK, Lee YZ, Lin W, Castillo M. Hemodynamic and permeability changes in posterior reversible encephalopathy syndrome measured by dynamic susceptibility perfusion-weighted MR imaging. AJNR Am J Neuroradiol. 2005;26(4):825–830
  • . Qureshi AI, Frankel MR, Ottenlips JR, Stern BJ. Cerebral hemodynamics in preeclampsia and eclampsia. Arch Neurol. 1996;53(12):1226–1231
  • . Shbarou RM, Chao NJ, Morgenlander JC. Cyclosporin A-related cerebral vasculopathy. Bone Marrow Transplant. 2000;26(7):801–804
  • . Bartynski WS, Boardman JF. Catheter angiography, MR angiography, and MR perfusion in posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol. 2008;29(3):447–455
  • . Chester EM, Agamanolis DP, Banker BQ, Victor M. Hypertensive encephalopathy: a clinicopathologic study of 20 cases. Neurology. 1978;28(9 pt 1):928–939
  • . Richards A, Graham D, Bullock R. Clinicopathological study of neurological complications due to hypertensive disorders of pregnancy. J Neurol Neurosurg Psychiatry. 1988;51(3):416–421
  • . Decker DA, Falchook AD, Yachnis AT, Waters MF. Radiographic and pathologic findings in an atypical brainstem variant of reversible posterior leukoencephalopathy syndrome. Neurologist. 2009;15(6):364–366
  • . Wilson SE, de Groen PC, Aksamit AJ, Wiesner RH, Garrity JA, Krom RA. Cyclosporin A-induced reversible cortical blindness. J Clin Neuroophthalmol. 1988;8(4):215–220
  • . Okeda R, Kawamoto T, Tanaka E, Shimizu H. An autopsy case of drug-induced diffuse cerebral axonopathic leukoencephalopathy: the pathogenesis in relation to reversible posterior leukoencephalopathy syndrome. Neuropathology. 2007;27(4):364–370
  • . Bartynski WS. Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol. 2008;29(6):1043–1049
  • . Wagner SJ, Acquah LA, Lindell EP, . Posterior reversible encephalopathy syndrome and eclampsia: pressing the case for more aggressive blood pressure control. Mayo Clin Proc. 2011;86(9):851–856
  • . Uwatoko T, Toyoda K, Hirai Y, . Reversible posterior leukoencephalopathy syndrome in a postpartum woman without eclampsia. Intern Med. 2003;42(11):1139–1143
  • . Digre KB, Varner MW, Osborn AG, Crawford S. Cranial magnetic resonance imaging in severe preeclampsia vs eclampsia. Arch Neurol. 1993;50(4):399–406
  • . Mueller-Mang C, Mang T, Pirker A, Klein K, Prchla C, Prayer D. Posterior reversible encephalopathy syndrome: do predisposing risk factors make a difference in MRI appearance? Neuroradiology. 2009;51(6):373–383
  • . Foyouzi N, Norwitz ER, Tsen LC, Buhimschi CS, Buhimschi IA. Placental growth factor in the cerebrospinal fluid of women with preeclampsia. Int J Gynaecol Obstet. 2006;92(1):32–37
  • . Lucas MJ, Leveno KJ, Cunningham FG. A comparison of magnesium sulfate with phenytoin for the prevention of eclampsia. N Engl J Med. 1995;333(4):201–205
  • . Bartynski WS, Tan HP, Boardman JF, Shapiro R, Marsh JW. Posterior reversible encephalopathy syndrome after solid organ transplantation. AJNR Am J Neuroradiol. 2008;29(5):924–930
  • . Saito B, Nakamaki T, Nakashima H, . Reversible posterior leukoencephalopathy syndrome after repeat intermediate-dose cytarabine chemotherapy in a patient with acute myeloid leukemia. Am J Hematol. 2007;82(4):304–306
  • . Sharief U, Perry DJ. Delayed reversible posterior encephalopathy syndrome following chemotherapy with oxaliplatin. Clin Colorectal Cancer. 2009;8(3):163–165
  • . Kaito E, Terae S, Kobayashi R, Kudo K, Tha KK, Miyasaka K. The role of tumor lysis in reversible posterior leukoencephalopathy syndrome. Pediatr Radiol. 2005;35(7):722–727
  • . D'Angelo P, Farruggia P, Lo Bello A, . Reversible posterior leukoencephalopathy syndrome: report of 2 simultaneous cases in children. J Pediatr Hematol Oncol. 2006;28(3):177–181
  • . Guyton AC. Cerebral blood flow, cerebrospinal fluid and brain metabolism. In: Guyton AC, Hall JE, eds. Textbook of Medical Physiology. Philadelphia, PA: Elsevier Saunders; 2006:761–768
  • . Hill GS. Studies on the pathogenesis of hypertensive vascular disease. Effect of high-pressure intra-arterial injections in rats. Circ Res. 1970;27(5):657–668
  • . MacKenzie ET, Strandgaard S, Graham DI, Jones JV, Harper AM, Farrar JK. Effects of acutely induced hypertension in cats on pial arteriolar caliber, local cerebral blood flow, and the blood-brain barrier. Circ Res. 1976;39(1):33–41
  • . Servillo G, Bifulco F, De Robertis E, . Posterior reversible encephalopathy syndrome in intensive care medicine. Intensive Care Med. 2007;33(2):230–236
  • . Schwartz RB, Mulkern RV, Gudbjartsson H, Jolesz F. Diffusion-weighted MR imaging in hypertensive encephalopathy: clues to pathogenesis. AJNR Am J Neuroradiol. 1998;19(5):859–862
  • . Häggendal E, Johansson B. On the pathophysiology of the increased cerebrovascular permeability in acute arterial hypertension in cats. Acta Neurol Scand. 1972;48(3):265–270
  • . Wartenberg KE, Parra A. CT and CT-perfusion findings of reversible leukoencephalopathy during triple-H therapy for symptomatic subarachnoid hemorrhage-related vasospasm. J Neuroimaging. 2006;16(2):170–175
  • . Dhar R, Dacey R, Human T, Zipfel G. Unilateral posterior reversible encephalopathy syndrome with hypertensive therapy of contralateral vasospasm: case report. Neurosurgery. 2011;69(5):E1176–E1181; E1181
  • . Burras TM, Mandrekar J, Wijdicks EF, Rabinstein AA. Renal failure and posterior reversible encephalopathy syndrome in patients with thrombotic thrombocytopenic purpura. Arch Neurol. 2010;67(7):831–834
  • . Zhang SZ, Wang ZH, Hu HS. Effects of intra-arterial perfusion of cisplatin combined with concomitant radiation therapy on the healing of microvascular anastomoses: an experimental study in rabbits [in Chinese]. Shanghai Kou Qiang Yi Xue. 2005;14(5):490–494
  • . Nuver J, De Haas EC, Van Zweeden M, Gietema JA, Meijer C. Vascular damage in testicular cancer patients: a study on endothelial activation by bleomycin and cisplatin in vitro. Oncol Rep. 2010;23(1):247–253
  • . Walker RW, Rosenblum MK, Kempin SJ, Christian MC. Carboplatin-associated thrombotic microangiopathic hemolytic anemia. Cancer. 1989;64(5):1017–1020
  • . Koide T, Yamada M, Takahashi T, . Cyclosporine A-associated fatal central nervous system angiopathy in a bone marrow transplant recipient: an autopsy case. Acta Neuropathol. 2000;99(6):680–684
  • . Beausang-Linder M, Bill A. Cerebral circulation in acute arterial hypertension—protective effects of sympathetic nervous activity. Acta Physiol Scand. 1981;111(2):193–199
  • . Edvinsson L, Owman C, Sjöberg NO. Autonomic nerves, mast cells, and amine receptors in human brain vessels. A histochemical and pharmacological study. Brain Res. 1976;115(3):377–393
  • . Porter A, Gladstone JP, Dodick DW. Migraine and white matter hyper-intensities. Curr Pain Headache Rep. 2005;9(4):289–293
  • . Long SS. Encephalitis diagnosis and management in the real world. Adv Exp Med Biol. 2011;697:153–173
  • . Limaye S, Cooper J. The right scan at the right time: reversible posterior leukoencephalopathy syndrome mimicking bilateral occipital lobe infarcts. Age Ageing. 2009;38(4):483–484
  • . Tan CS, Koralnik IJ. Progressive multifocal leukoencephalopathy and other disorders caused by JC virus: clinical features and pathogenesis. Lancet Neurol. 2010;9(4):425–437
  • . Calabrese LH, Dodick DW, Schwedt TJ, Singhal AB. Narrative review: reversible cerebral vasoconstriction syndromes. Ann Intern Med. 2007;146(1):34–44
  • . Ito T, Sakai T, Inagawa S, Utsu M, Bun T. MR angiography of cerebral vasospasm in preeclampsia. AJNR Am J Neuroradiol. 1995;16(6):1344–1346
  • . Singhal AB. Postpartum angiopathy with reversible posterior leukoencephalopathy. Arch Neurol. 2004;61(3):411–416
  • . Chen SP, Fuh JL, Wang SJ, . Magnetic resonance angiography in reversible cerebral vasoconstriction syndromes. Ann Neurol. 2010;67(5):648–656
  • . Singhal AB, Hajj-Ali RA, Topcuoglu MA, . Reversible cerebral vasoconstriction syndromes: analysis of 139 cases. Arch Neurol. 2011;68(8):1005–1012
  • . Limaye S, Cooper J. The right scan at the right time: reversible posterior leukoencephalopathy syndrome mimicking bilateral occipital lobe infarcts. Age Ageing. 2009;38(4):483–484
  • . Kaal EC, Vecht CJ. The management of brain edema in brain tumors. Curr Opin Oncol. 2004;16(6):593–600
  • . Honkaniemi J, Kähärä V, Dastidar P, . Reversible posterior leukoencephalopathy after combination chemotherapy. Neuroradiology. 2000;42(12):895–899
  • . Sasayama D, Shimojima Y, Gono T, Kaneko K, Matsuda M, Ikeda S. Henoch-Schönlein purpura nephritis complicated by reversible posterior leukoencephalopathy syndrome. Clin Rheumatol. 2007;26(10):1761–1763
  • . Nishio M, Yoshioka K, Yamagami K, . Reversible posterior leukoencephalopathy syndrome: a possible manifestation of Wegener's granulomatosis-mediated endothelial injury. Mod Rheumatol. 2008;18(3):309–314
  • . Irvin W, MacDonald G, Smith JK, Kim WY. Dexamethasone-induced posterior reversible encephalopathy syndrome. J Clin Oncol. 2007;25(17):2484–2486
  • . Zar T, Samson W, Palmisano J. Reversible posterior leukoencephalopathy syndrome (RPLS) in a patient with systemic lupus erythematosus (SLE) and lupus nephritis. Nephrol Dial Transplant. 2007;22(8):2400–2401

Reprints and Corporate Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

To request a reprint or corporate permissions for this article, please click on the relevant link below:

Academic Permissions

Please note: Selecting permissions does not provide access to the full text of the article, please see our help page How do I view content?

Obtain permissions instantly via Rightslink by clicking on the button below:

If you are unable to obtain permissions via Rightslink, please complete and submit this Permissions form. For more information, please visit our Permissions help page.