Posterior reversible encephalopathy syndrome with lumbar drainage and surgery: coincidence or correlation? A case report.

Journal Article (Journal Article)

BACKGROUND: Posterior reversible encephalopathy syndrome (PRES) is a rare neurological disorder usually associated with specific medical conditions that cause a disturbance of the CNS homeostasis. It has seldom been reported to be a consequence of an iatrogenic intervention causing intracranial hypotension. CASE PRESENTATION: We report the case of an individual 69-year-old male presenting with headache and blurred vision following cerebrospinal fluid (CSF) leak from resection of a sellar mass. The patient developed the condition following removal of the lumbar drain post-operatively. Magnetic Resonance Imaging showed bilateral occipital, parieto-occipital, and cerebellar T2 FLAIR hyper-intensities, suggesting a radiological diagnosis of posterior reversible encephalopathy syndrome (PRES). The patient's symptoms started to improve shortly afterwards and had completely resolved at 3 months follow-up. CONCLUSIONS: The absence of severe hypertension and presence of an intraoperative CSF leak requiring placement of the lumbar drain suggests that decreased CSF volume and associated reactive hyperemia could have a role in the pathophysiology of the disease.

Full Text

Duke Authors

Cited Authors

  • Oxford, BG; Khattar, NK; Adams, SW; Schaber, AS; Williams, BJ

Published Date

  • August 30, 2019

Published In

Volume / Issue

  • 19 / 1

Start / End Page

  • 214 -

PubMed ID

  • 31470816

Pubmed Central ID

  • PMC6716908

Electronic International Standard Serial Number (EISSN)

  • 1471-2377

Digital Object Identifier (DOI)

  • 10.1186/s12883-019-1438-8

Language

  • eng

Conference Location

  • England