PRES: A Key diagnosis by neuroimaging

Abstract

69-year-old female patient with history of hypertension and hypothyroidism. Presented with fixed gaze, mutism, right brachio-crural hemiparesis, and elevated blood pressure. Head CT scan was normal, but brain MRI FLAIR images showed multiple hyperintensities in the occipital lobe (Figure 1-A), without evidence of acute ischemic stroke on DWI and ADC (Figure 1, B and C). This pattern suggested Posterior Reversible Encephalopathy Syndrome (PRES), characterized by vasogenic edema in parieto-occipital regions. Management focused on blood pressure control, resulting in improvement of neurological symptoms.