The Analysis Of Clinical Imaging And Etiology In Reversible Posterior Encephalopathy Syndrome

ObjectiveTo investigate clinical, imaging characteristic and etiology of the reversible posterior encephalopathy syndrome(RPES).MethodClinical and MRI materials of 10 RPES cases conformed by integrated clinical diagnosis were retrospectively analyzed.Result9 cases of 10 presented with a rise of blood pressure. The neural symptoms include headache (7cases), consciousness disorders (7cases), dysphoria (2cases), seizure (7 cases), visual disturbance (3 cases), weakness and movement disorders (1 case). In MRI, the lesions mainly located in parietal lobe, occipital lobe and frontal lobe, also located in temporal lobe, brain stem, basal ganglia and cerebellum. Lesions demonstrated hyperintense on T2 weighted and Flair sequences, hypointensity or isointensity on T1 weighted, and isointensity on diffusion-weighted images (DWI). Lesions located in cortex, white matter or both the cortex and subcortical white matter. The etiologies are renal artery stenosis, adrenal glands goiter, acute kidney insufficiency, secondary hypertension followed by glomerulonephritis, essential hypertension, eclampsia in puerperium and immunosuppressive agents.ConclusionThe primary clinical findings of RPES are a rise of blood pressure, headache, consciousness disorders, seizure, and hypertension is not necessary. RPES represents such characteristic MRI findings as symmetrical distribution of reversible lesions in posterior brain with involvement of cortex and subcortical or the both, which is criticality of diagnosis. It is result of various condition, mainly the rise of blood pressure.