Imaging intracranial hemorrhage – Case 3 – PRES – posterior reversible encephalopathy syndrome

Sometimes other features give you a clue as to why a patient may have hemorrhage. This patient with melanoma history was certainly concerning for metastatic disease. However, there was no underlying enhancing lesion and there were multiple other areas of white matter edema, also without enhancement.

The recent history of chemotherapy made this case suspicious for PRES, posterior reversible encephalopathy syndrome, also sometimes called acute hypertensive encephalopathy. It can be a bit confusing, because it isn’t always posterior, reversible, or encephalopathy. Hence the confusing number of names.

However, conservative management in this patient showed resolution of the majority of the findings within 4 weeks without metastatic disease.

The level of this lecture is appropriate for medical students, junior residents, and trainees in other specialties who have an interest in neuroradiology or may see patients with intracranial hemorrhage or stroke.

Check out the full Youtube playlist to see the entire lecture.