Unilateral Reversible Posterior Leukoencephalopathy Syndrome After Coiling of an Aneurysm

Overview

Journal J Clin Neurol

Specialty Neurology

Date 2014 Jan 28

PMID 24465265

Citations 9

Authors

Willemijn Huijgen

Bas van der Kallen

Jelis Boiten

Geert Lycklama A Nijeholt

Affiliations

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Abstract

Background: Reversible posterior leukoencephalopathy syndrome (RPLS) is radiologically characterized by symmetrical subcortical areas of vasogenic edema that are preferentially parieto-occipital, and it typically resolves after appropriate treatment.

Case Report: We present a patient with strikingly unilateral RPLS that developed 21 days after coiling of an anterior communicating artery aneurysm and several days of triple-H therapy. Cortical and subcortical vasogenic edema and enhancement developed only in the left hemisphere, with a pattern suggesting RPLS. After 7 months the lesions had nearly completely resolved.

Conclusions: The pathophysiological mechanism underlying RPLS is still not well understood, which makes it difficult to explain the unilateral appearance in this case. Since the imaging findings may be confused with other conditions such as ischemia, recognition of RPLS after coiling is necessary in order to avoid inadequate treatment.

Citing Articles

Clinical and Radiological Features of Unilateral Posterior Reversible Encephalopathy Syndrome (PRES): A Case Report.

Makkawi S, Khojah O, Baeshen S, Ahmed M Cureus. 2024; 16(4):e58774.

PMID: 38784364 PMC: 11111322. DOI: 10.7759/cureus.58774.

Asymmetric posterior reversible encephalopathy syndrome secondary to epilepsy occurring in the chronic phase of subarachnoid hemorrhage.

Matsumoto A, Hanayama H, Matsumoto H, Tomogane Y, Minami H, Masuda A Surg Neurol Int. 2022; 13:129.

PMID: 35509559 PMC: 9062910. DOI: 10.25259/SNI_244_2022.

Delayed Leukoencephalopathy and Foreign Body Reaction After Endovascular Treatment in Patients With Intracranial Aneurysms and Aneurysmal Subarachnoid Hemorrhage-A Systematic Review of the Literature.

Ridwan S, Kandyba J, Schug A, Malsagov E, Karageorgos N, Hans F Front Surg. 2022; 8:732603.

PMID: 35004833 PMC: 8733731. DOI: 10.3389/fsurg.2021.732603.

Data on characteristics of reported cases of unilateral posterior reversible encephalopathy syndrome (PRES).

Ozawa T, Tanaka R, Nagaoka R, Anan Y, Kim Y, Matsuzono K Data Brief. 2019; 27:104648.

PMID: 31687449 PMC: 6820304. DOI: 10.1016/j.dib.2019.104648.

The effect of carotid occlusive disease on the distribution of brain lesions in patients with systemic conditions-an example of PRES.

Kuhn A, Siddalingappa A, Chang Y, Bhadelia R Radiol Case Rep. 2019; 14(9):1136-1139.

PMID: 31360275 PMC: 6639678. DOI: 10.1016/j.radcr.2019.06.028.

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