Data research
the radiological report data bases of the authors´ university hospitals were searched from 1999 to 2010 for:
•posterior reversible encephalopathy syndrom,
PRES,
neurotoxicity
•drugs: Cyclosporin,
FK506,
Tacrolimus
•predisposing disorders:
–eclampsia,
preeclampsia,
toxemia of pregnancy
–hypertensive encephalopathy
–autoimmunologic: lupus erythematodes,
SLE,
sclerodermia,
Wegener‘s granulomatosis
Study inclusion
•after review of all Neuro-MRIs: 141 cases of possible PRES
•in consensus with a neurologist taking all Neuro-MRIs and all medical reports into account: 94 cases of definite PRES
Edema grading
•Grade 1: circumscript edema of cortex and adjacent white matter
•Grade 2: edema of cortex and white matter with circumscript deep extension
•Grade 3: edema of cortex and white matter with circumscript extension to the ventricles
•Grade 4: diffusely confluent edema of cortex and white matter with broad extension to the ventricles
•Grade 5: diffusely confluent edema of cortex and white matter with ventricle deformity
Localisation
•Lobar: frontal,
parietal,
occipital,
temporal
•Basal ganglia: Striatum,
Pallidum
•Diencephalon: Thalamus,
Hypothalamus
•Midbrain
•Pons
•Cerebellum
•Medulla oblongata
•Corpus callosum
Lesion distribution
•„classical“ dominant parieto-occipital pattern
•superior frontal sulcus pattern
•holohemispheric watershed pattern
•central pattern
•partial/ asymmetric expression
Hemorrhage
•parenchymal hemorrhage
•subarachnoid hemorrhage
•microbleeds (< 5mm T2*)
Diffusivity
•facilitated (ADC increased)
•normal
•restricted (ADC reduced)
Blood - brain barrier disruption
•leptomeningeal
•cortical/ parenchymal
Vasculopathy
•vasoconstrictions
•vasodilatations
•alternating luminal irregularities (string of beads)