Perioperative posterior reversible encephalopathy syndrome in a patient with no history of hypertension: a case report

JA Clinical Reports
Nobuo SatoMakiko Komori

Abstract

Posterior reversible encephalopathy syndrome is characterized by reversible neurological symptoms with leukoencephalopathy detectable by computed tomography (CT) and magnetic resonance (MR) imaging. We here present a patient with no history of hypertension who, after being transferred back to the ward after undergoing total hysterectomy under general anesthesia, had several seizures and lost consciousness. Posterior reversible encephalopathy syndrome was suspected on the basis of brain CT images and clinical findings. She was treated with respiratory support, sedative drugs, and anticonvulsants, and MR imaging confirmed a diagnosis of posterior reversible encephalopathy syndrome. She regained consciousness and responsiveness the following day. Clinically, posterior reversible encephalopathy syndrome resembles cerebral infarction or intracranial hemorrhage; MR imaging is useful for differentiating it from these conditions. Including this condition in the differential diagnosis and instituting appropriate treatment is important in minimizing the risk of development of irreversible neurological damage during the perioperative period.

References

Feb 22, 1996·The New England Journal of Medicine·J HincheyL R Caplan
May 1, 1997·Stroke; a Journal of Cerebral Circulation·P W SchaeferL H Schwamm
Aug 19, 2007·AJNR. American Journal of Neuroradiology·W S Bartynski, J F Boardman
Sep 2, 2011·Anesthesiology·David W BarbaraJames A Onigkeit
Sep 14, 2011·Journal of Clinical Anesthesia·Ramez GharabawyAsaf A Gave
Oct 21, 2011·Journal of Anesthesia·Satoki InoueHitoshi Furuya
Feb 1, 2013·Anesthesiology·Jeffrey L ApfelbaumUNKNOWN American Society of Anesthesiologists Task Force on Postanesthetic Care

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Methods Mentioned

BETA
hysterectomy

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