Atypical imaging findings in a near-fatal case of posterior reversible encephalopathy syndrome in a child.

摘要

Tterm "posterior reversible en-phalopathy syndrome" (PRES) fers to a complex of symptoms ually manifested by headache, confusion, seizures, visual disturbances, or a combination of these symptoms. PRES usually occurs in the setting of an acute rise in blood pressure, and in recent years, PRES has been recognized as a complication of immunosuppressive and chemotherapeutic agents including cyclosporine A and L-asparaginase . Imaging findings are characteristic and consist of typically unenhancing lesions that predominate in the white matter of the posterior brain regions, seen as hypodense regions on CT and hyperintense areas on T2-weighted MR images. We report an unusual case in which a child with PRES developed contrast-enhancing lesions with marked mass effect in the posterior fossa that resulted in cerebellar tonsillar herniation and cardiac arrest.