We report a case of malignant posterior reversible encephalopathy syndrome (PRES) in a 62-year-old Caucasian female with a complex medical history and comorbidities admitted for bowel resection and lysis of iatrogenic bowel adhesions and enterocutaneous fistulas. Postoperatively, the patient developed sudden bilateral visual loss with no other neurologic deficits. Computed tomography scan showed very severe PRES-like changes, confirmed on magnetic resonance imaging (MRI). Systolic blood pressure remained around 170 mm HG. The patient was obtunded and remained unresponsive after MRI, with minimal response and a deteriorating clinical condition. The patient was given hyperosmolar therapy with a mannitol bolus. She recovered well with near resolution of imaging findings.
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机译:我们报告了一名62岁的白人女性的恶性后可逆性脑病综合征(PRES)的病例,该病患者具有复杂的病史和合并症,因肠切除和医源性肠粘连和肠内皮肤瘘管溶解而入院。术后,患者突然出现双侧视力丧失,无其他神经系统缺陷。计算机断层扫描显示非常严重的PRES样变化,已通过磁共振成像(MRI)确认。收缩压保持在170 mm HG附近。该患者在MRI检查后不知所措,仍然无反应,反应极少且临床状况恶化。给予患者甘露醇大剂量高渗治疗。她恢复良好,影像学检查结果近乎分辨率。
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