Posterior Reversible Ensefalopati Sendromu (PRES) Olgularının Retrospektif Olarak Analizi: Acil Servis Başvuruları
Abstract
ÖZET
Giriş; Posterior
reversible ensefalopati sendromu (PRES) , nörolojik ve radyolojik bulguların eşlik ettiği geri döndürülebilir
bir sendromdur. İlk olarak 1996 yılında Hınchey J ve ark. tarafından tanımlanan
bu sendrom genellikle hipertansiyon, baş ağrısı, konfüzyon, konvülziyon,kusma
ve görme bozukluğunun eşlik ettiği geri döndürülebilir bir hastalık olarak literatüre geçmiştir.
Patofizyolojisinde iki hipotez öne sürülmüştür, birincisi aniden yükselen tansiyona bağlı olarak
serebral hiperperfüzyon ve buna bağlı vazojenik ödem, ikincisi ise endojen ve eksojen toksinlerin neden olduğu
endotel disfonksiyonudur. Klinik olarak çeşitli nörolojik semptomlarla
karekterize olup, akut veya subakut gelişebilir. Birkaç saat sürebildiği gibi
günler ve haftalarca da sürebilir.
Gereç ve Yöntem; Bu çalışma
2012-2017 yılları arasında Adıyaman Üniversitesi Tıp Fakültesi Acil Servise
başvuran hastalar arasından retrospektif olarak yapıldı. Baş ağrısı,
ensefalopati, nöbet, görme bozukluğu veya fokal nörolojik defekti içeren akut
başlangıçlı nörolojik semptomlar ve
beyin görüntülemesinde fokal vazojenik ödem tespit edilen beş PRES olgusu çalışmaya alındı. Olgular yaş, cinsiyet,
acil servise başvuru şikayeti,kronik hastalık, gebelik durumu, BBT,MR ve
elektroensefalografik (EEG) bulgularına göre sınıflandırıldı.
Sonuç olarak; acil servise baş ağrısı, görme kaybı,
bilinç kaybı ve özellikle konvülziyonla başvuran kadın ve gebelerde PRES akla
gelmelidir.
Anahtar
Kelimeler:
PRES, acil servis, konvülziyon
ABSTRACT
Background: Posterior reversible encephalopathy
syndrome (PRES) is a reversible syndrome accompanied by neurological and
radiological findings by Hynchy J et al. in 1996 . This syndrome is often referred with
hypertension, headache, confusion, convulsions, vomiting, and loss of vision.Two
hypotheses have been proposed for pathophysiology. The first being cerebral
hyperperfusion due to suddenly elevated blood pressure and the associated
vasogenic edema and the second endothelial dysfunction caused by endogenous and
exogenous toxins. It is clinically characterized by various neurological
findings which may develop acutely or subacutely. It can last for several hours or days and
weeks.
Material
and method: This study was retrospectively performed between
Adiyaman University Faculty of Medicine Emergency Service between 2012-2017. Acute onset
neurological symptoms including headache, encephalopathy, seizure, visual impairment
or focal neurologic deficit, and five PRES cases with focal vasogenic edema on
brain imaging were included in the study. The cases were classified according to age, gender,
complaint of emergency service, chronic disease, pregnancy status, BBT, MR and
electroencephalographic (EEG) findings.
Conclusion: As a result;
emergency headache, visual loss, loss of consciousness, and PRES in women and
pregnant women, especially those who are referred for convulsions.
Keywords: PRES,emergency,
convulsions
Keywords
References
- KAYNAKLAR 1) Fischer M, Schmutzhard E (2017), Posterior reversible encephalopathy syndrome, J Neurol DOI 10.1007/s00415-016-8377-8
- 2) Hinchey J. et al. "A reversible posterior leukoencephalopathy syndrome." New England Journal of Medicine 334.8 (1996): 494-500.
- 3) Fugate JE, Rabinstein AA (2015) Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol 14(9):914–925.
- 4) Kutlu, Ayşe, et al. "A Case of Chronic Renal Failure and Recurrent Posterior Reversible Encephalopathy Syndrome." NOROPSIKIYATRI ARSIVI-ARCHIVES OF NEUROPSYCHIATRY 48.4 (2011): 270-273.
- 5) Tekflam M, Casey S.O,Michel E,Truwit C.L.Posterior reversible ensefalopati sendromu:patofizyoloji ve ileri MRG teknikleri korelasyonu.Tanısal ve Girişimsel Radyoloji (2001) 7:464-472.
- 6) Oğuztürk, H., Turtay, M. G., Doğan, M., Gönüllü, S., & Çelik, E. PRES’e Bağlı Ani Gelişen Bilateral Görme Kaybı. Akademik Acil Tıp Olgu Sunumları Dergisi 2010, Cilt:1 Sayı:2.
- 7) Kwon S, Jahoon K, Sangkwon L (2001) Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Pediatr Neurol 24: 361–364 8) Schaefer PW, Buonanno FS, Gonzales RG, Schwamm LH (1997) Diffusionweighted imaging discriminates between cytotoxic and vasogenic edema in a patient with eclampsia. Stroke 28:1082–1085. 9) Covarrubias DJ, Luetmer PH, Campeau NG (2002) Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusionweighted MR images. Am J Neuroradiol 23:1038–1048. 10) Keswani SC, Wityk R (2002) Don’t throw in the towel! A case of reversible coma. J Neurol Neurosurg Psychiatry 73:83–84. 11) Sagut O, Çinar BP. Dramatic improvement in severe posterior reversible encephalopathy syndrome in a case of eclampsia. FNG & Bilim Tıp Dergisi 2016;2(2):145-148. 12) MacKenzie ET, Strandgaard S, Graham DI, Jones JV, Harper AM, Farrar JK. Effects of acutely induced hypertension in cats on pial arteriolar caliber, local cerebral blood flow, and the blood-brain barrier. Circ Res 1976;39:33-41 13) Kastrup O,Gerwig M,Frings M,Diener HC. Posterior reversible encephalopaty syndome(PRES):electroencephalographic findings and seizure patterns.J Neurol.2012.Jul;259(7):1383-9.
Abstract
References
- KAYNAKLAR 1) Fischer M, Schmutzhard E (2017), Posterior reversible encephalopathy syndrome, J Neurol DOI 10.1007/s00415-016-8377-8
- 2) Hinchey J. et al. "A reversible posterior leukoencephalopathy syndrome." New England Journal of Medicine 334.8 (1996): 494-500.
- 3) Fugate JE, Rabinstein AA (2015) Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol 14(9):914–925.
- 4) Kutlu, Ayşe, et al. "A Case of Chronic Renal Failure and Recurrent Posterior Reversible Encephalopathy Syndrome." NOROPSIKIYATRI ARSIVI-ARCHIVES OF NEUROPSYCHIATRY 48.4 (2011): 270-273.
- 5) Tekflam M, Casey S.O,Michel E,Truwit C.L.Posterior reversible ensefalopati sendromu:patofizyoloji ve ileri MRG teknikleri korelasyonu.Tanısal ve Girişimsel Radyoloji (2001) 7:464-472.
- 6) Oğuztürk, H., Turtay, M. G., Doğan, M., Gönüllü, S., & Çelik, E. PRES’e Bağlı Ani Gelişen Bilateral Görme Kaybı. Akademik Acil Tıp Olgu Sunumları Dergisi 2010, Cilt:1 Sayı:2.
- 7) Kwon S, Jahoon K, Sangkwon L (2001) Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Pediatr Neurol 24: 361–364 8) Schaefer PW, Buonanno FS, Gonzales RG, Schwamm LH (1997) Diffusionweighted imaging discriminates between cytotoxic and vasogenic edema in a patient with eclampsia. Stroke 28:1082–1085. 9) Covarrubias DJ, Luetmer PH, Campeau NG (2002) Posterior reversible encephalopathy syndrome: prognostic utility of quantitative diffusionweighted MR images. Am J Neuroradiol 23:1038–1048. 10) Keswani SC, Wityk R (2002) Don’t throw in the towel! A case of reversible coma. J Neurol Neurosurg Psychiatry 73:83–84. 11) Sagut O, Çinar BP. Dramatic improvement in severe posterior reversible encephalopathy syndrome in a case of eclampsia. FNG & Bilim Tıp Dergisi 2016;2(2):145-148. 12) MacKenzie ET, Strandgaard S, Graham DI, Jones JV, Harper AM, Farrar JK. Effects of acutely induced hypertension in cats on pial arteriolar caliber, local cerebral blood flow, and the blood-brain barrier. Circ Res 1976;39:33-41 13) Kastrup O,Gerwig M,Frings M,Diener HC. Posterior reversible encephalopaty syndome(PRES):electroencephalographic findings and seizure patterns.J Neurol.2012.Jul;259(7):1383-9.
Details
| Primary Language | Turkish |
|---|---|
| Subjects | Health Care Administration |
| Journal Section | Research Article |
| Authors | |
| Publication Date | January 15, 2016 |
| Submission Date | September 26, 2017 |
| Acceptance Date | December 2, 2017 |
| Published in Issue | Year 2016 Volume: 2 Issue: 1 |
