Posterior reversible encephalopathy syndrome : our experience at King Hussein Medical Center

Abstract EN

Objective : to describe and determine the frequency of brain Magnetic Resonance Imaging findings for regional involvement of brain lobes in Posterior Reversible Encephalopathy Syndrome.

Methods : this is a descriptive study which was conducted on a total of 13 patients who were diagnosed by Magnetic Resonance Imaging to have Posterior Reversible Encephalopathy Syndrome during the period between July 2009 to September 2011 at King Hussein Medical Center.

Criteria for diagnosing Posterior Reversible Encephalopathy Syndrome include partial or complete expression of Posterior Reversible Encephalopathy Syndrome pattern, reversibility of the edema on follow up images, clinical presentation of neurotoxicity and presence of underlying systemic process.

Standard Magnetic Resonance Imaging sequences used were unenhanced T1-T2-FLAIR diffusion-weighted and contrast-enhanced T1-weighted imaging Results : the frequency of regional involvement of brain lobes in Posterior Reversible Encephalopathy Syndrome in this series were as follows; the occipital lobe being affected with reversible vasogenic edema in all 13 patients (100 %), followed by the parietal lobe in 10 patients (76.9 %), frontal lobe in 8 patients (61.5 %), temporal lobe in 2 patients (15.4 %) cerebellar in 2 patients (15.4 %) and pons in one patient (7.7 %).

The involvement was almost symmetrical bilateral in 9 patients (75 %) Conclusion : neuroradiological findings along with clinical signs are consistent enough so that this entity should be readily recognizable which ensures early treatment, also prevention of potential complications as brain hemorrhage and infarction.