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• W2059784858 abstract "Posterior reversible encephalopathy (PRES) represents an uncommon entity related to multiple pathologies, the most common of which is hypertensive crisis. PRES is classically characterized as symmetrical parieto-occipital edema, but may affect other areas of the brain. Diffusion-weighted magnetic resonance imaging (DWI) is important for differentiating between vasogenic and cytotoxic edema. We present here the case of a 43-year-old woman, known to suffer from arterial hypertension and severe renal failure, who developed PRES with restricted apparent diffusion coefficients (ADC) in various cerebral areas, suggesting irreversible tissue damage. Nevertheless, follow-up cranial MRI revealed complete remission, indicating that restricted diffusion does not always lead to cell death in this pathology. The underlying pathophysiological mechanism is not well understood. Such reversibility of diffusion anomalies has already been reported with transient ischemia, vasospasm after subarachnoid hemorrhage and epilepsy but, to our knowledge, never before in PRES. L’encéphalopathie postérieure réversible représente une entité assez rare, secondaire à différentes pathologies, la crise hypertensive étant la plus fréquente. Elle est classiquement caractérisée par un œdème pariéto-occipital bilatéral, mais peut toucher d’autres régions. L’imagerie de diffusion est importante pour la différenciation entre l’œdème vasogénique et cytotoxique. Nous présentons le cas d’une patiente âgée de 43 ans, ayant comme antécédent une hypertension artérielle et une insuffisance rénale sévère, qui a développé une encéphalopathie postérieure réversible avec des lésions cérébrales caractérisées par un coefficient apparent de diffusion (CAD) diminué, suggérant des lésions tissulaires irréversibles. L’IRM cérébrale de contrôle a cependant montré la régression quasi complète des lésions, démontrant qu’une baisse de la diffusion ne doit pas toujours faire supposer la mort cellulaire dans cette pathologie. Le mécanisme sous-jacent n’est pas parfaitement compris. Une telle réversibilité des anomalies en diffusion a déjà été décrite dans l’accident ischémique transitoire, le vasospasme après hémorragie sous-arachnoïdienne, et dans l’épilepsie, mais à notre connaissance, pas encore dans l’encéphalopathie postérieure réversible." @default.
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• W2059784858 date "2009-05-01" @default.
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• W2059784858 title "Posterior reversible encephalopathy syndrome: A case of unusual diffusion-weighted MR images" @default.
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• W2059784858 doi "https://doi.org/10.1016/j.neurad.2008.08.003" @default.
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