Life-threatening posterior reversible encephalopathy syndrome in the cerebellum treated by posterior fossa decompression.

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Life-threatening posterior reversible encephalopathy syndrome in the cerebellum treated by posterior fossa decompression.

Acta Neurochir (Wien). 2017 Jul;159(7):1325-1328

Authors: Abusabha Y, Petridis AK, Kraus B, Kamp MA, Steiger HJ, Beseoglu K

Abstract
Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuroradiological syndrome associated with various clinical conditions, such as headache, encephalopathy, and seizures. It is reversible if a prompt diagnosis is made and treatment undertaken. We report a 52-year-old male with hypertensive crisis. Progressing somnolence and an unresponsive left pupil occurred. MRI revealed an intra-axial hyperintensity of the cerebellum and brainstem and occlusive hydrocephalus suggestive of encephalitis or a tumor. Because of the life-threatening clinical picture, posterior fossa decompression was performed. Histopathology failed to identify any pathology. After decompression, the edema improved immediately. Under life-threatening conditions, a decompressive craniectomy in PRES seems to achieve the same results as supportive treatment.

PMID: 28547518 [PubMed - indexed for MEDLINE]

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