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Query: UMLS:C0018681 (headache)
 56,091 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Reversible posterior leukoencephalopathy (RPLS), also known as posterior reversible encephalopathy syndrome, is characterized by magnetic resonance imaging (MRI) findings of reversible vasogenic subcortical edema without infarction. The clinical presentation is usually nonspecific and typically involves global encephalopathy, seizures, headache, or visual symptoms. MRI of the brain is essential to the diagnosis of RPLS. Typical findings of RPLS include high-intensity signal on T2-weighted images predominantly in the posterior lobes of the brain that is caused by subcortical white matter vasogenic edema. Fluid-attenuated inversion recovery (FLAIR) sequences on MRI improve sensitivity and detect subtle peripheral lesions. This clinical radiographic syndrome has been described in a number of medical conditions, with hypertensive encephalopathy, eclampsia, and the use of immunosuppressant drugs (most notably calcineurin inhibitors) being the most common. It has occasionally been reported with cisplatin and rarely with carboplatin. Its occurrence with oxaliplatin is very unusual. An extensive literature search including PUBMED and direct contact with the drug manufacturer yielded only 2 known case reports. Herein, we describe a case that had classic clinical and radiologic features of RPLS. We also briefly describe 2 other patients who have been described to have RPLS with oxaliplatin in the literature.
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PMID:Delayed reversible posterior encephalopathy syndrome following chemotherapy with oxaliplatin. 1963 31

Reversible posterior leukoencephalopathy syndrome (RPLS) is recently described disorder with typical radiological findings in the posterior regions of the cerebral hemisphere and cerebellum. Its clinical symptoms include headache, decreased alertness, mental abnormalities, such as confusion, diminished spontaneity of speech, and changed behavior ranging from drowsiness to stupor, seizures, vomiting and abnormalities of visual perception like cortical blindness. RPLS is caused by various heterogeneous factors, the commonest being hypertension, followed by non-hypertensive causes such as eclampsia, renal diseases and immunosuppressive therapy. We presented nine patients with RPLS who had primary diagnoses such as acute post-streptococcal glomerulonephritis, idiopathic hypertension, the performing of intravenous immunoglobulin for infection with crescentic glomerulonephritis, erythrocyte transfusion for severe iron deficiency, L: -asparaginase treatment for acute lymphoblastic leukemia and performing of granulocyte-colony stimulating factor for ulcerative colitis due to neutropenia. Early recognition of RPLS as complication during different diseases and therapy in childhood may facilitate precise diagnosis and appropriate treatment.
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PMID:Reversible posterior leukoencephalopathy syndrome in childhood: report of nine cases and review of the literature. 1980 87

Few studies establishing clear criteria for the medical interruption of a pregnancy complicated by PE are available today. Most of these studies are either retrospective or observational. When combining an analysis of the available literature together with the experts' opinions, one can propose the following set of criteria for therapeutic interruption of pregnancy in the setting of PE, which apply mainly for the severe forms of the disease. These criteria can be subdivided into maternal and fetal criteria. Maternal criteria are a severe uncontrollable HT, eclampsia, acute pulmonary edema, retro placental haematoma, oligura (<100 ml in 4 hours) resistant to appropriate fluid expansion, persistent signs of imminent eclampsia (headache or visual disturbances), persistent epigastric pain, HELLP syndrome, new-onset renal failure and a gestation time within the first 24 weeks. The fetal criteria are prolonged and variable fetal heart rate (FHR) decelerations, a short term variability in FHR <3 bpm, a Manning score < or =4 on two separate occasions, severe oligohydramnios, an estimated fetal weight below the 5(th) percentile beyond the 32(nd) week of amenorrhea and an inverted diastolic flow in the umbilical artery beyond the 32(nd) week of amenorrhea. In case of non-severe PE beyond the 36(th) week of amenorrhea, interruption of the pregnancy must be considered.
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PMID:[Criteria of pregnancy termination in women with preeclampsia]. 2034 61

Posterior Reversible Encephalopathy Syndrome (PRES) refers to a clinicoradiologic entity with characteristic features on neuro-imaging and non-specific symptoms comprising headache, confusion, visual disturbances and seizures. The lesions in PRES are thought to be due to vasogenic oedema, predominantly in the posterior cerebral hemispheres, and are reversible with appropriate management. We report 3 cases of acute PRES who had eclampsia and presented with recurrent episodes of seizures and hypertension. Their MRI scan showed diffuse abnormal signal intensities involving predominantly deep white matter of the occipital lobes. Based on the findings the most probable diagnosis of PRES was suggested. They were started on antihypertensive drugs. On follow-up examination after 5-7 weeks, the patients showed marked improvement clinically and on neuro-imaging following which they were discharged in stable condition.
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PMID:Posterior reversible encephalopathy syndrome: a case series in patients with eclampsia. 2052 17

Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome that manifests with the onset of headache, confusion or decreased level of consciousness, visual changes, and seizures in conjunction with the typical neuroimaging features of posterior cerebral white matter changes, which are usually reversible. This syndrome has been associated with hypertension, eclampsia, renal insufficiency, immunosuppressive drugs, and connective-tissue diseases. To our knowledge, only four cases of PRES associated with antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis have been reported in the literature. Here, we present a patient with ANCA-associated vasculitis complicated by PRES.
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PMID:Posterior reversible encephalopathy syndrome in a patient with ANCA-associated vasculitis. 2176 Nov 96

Reversible posterior leukoencephalopathy (RPLE) syndrome is clinically associated with headache, altered consciousness, seizures and visual symptoms. On brain magnetic resonance imaging (MRI) there is edema predominantly affecting white matter of the parietooccipital brain regions. Initially, this syndrome was believed to be secondary to hypertension, renal disease, or immunosuppressive therapy. However, it has recently been identified in a wide variety of conditions, including eclampsia, hemolytic-uremic syndrome, connective tissue diseases, malignancies, etc. Authors describe a case of a 72-year-old woman with a history of arterial hypertension, who suddenly developed headache, confusion, left homonymous hemianopsia, and left hemiparesis, associated with high blood pressure. Brain MRI revealed extensive white matter lesion in the right parietal and occipital lobe, splenium corpus callosum and left occipital lobe, suggestive of expansive process. However, after extensive diagnostic work-up, diagnosis of reversible posterior leukoencephalopathy was established, connected with arterial hypertension. At the moment the patient is without neurological symptoms, follow-up brain MRI revealed resolution of white matter lesion.
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PMID:[Reversible posterior leukoencephalopathy or brain tumor--case report]. 2067 21

Background. Cervicocephalic arterial dissection (CCAD) is rare in the postpartum period. To our knowledge this is the first reported case of postpartum angiopathy (PPA) presenting with ischemic stroke due to intracranial arterial dissection. Case. A 41-year-old woman presented with blurred vision, headache, and generalized seizures 5 days after delivering twins. She was treated with magnesium for eclampsia. MRI identified multiple posterior circulation infarcts. Angiography identified a complex dissection extending from both intradural vertebral arteries, through the basilar artery, and into both posterior cerebral arteries. Multiple segments of arterial dilatation and narrowing consistent with PPA were present. Xenon enhanced CT (Xe-CT) showed reduced regional cerebral blood flow that is improved with elevation in blood pressure. Conclusion. Intracranial vertebrobasilar dissection causing stroke is a rare complication of pregnancy. Eclampsia and PPA may play a role in its pathogenesis. Blood pressure management may be tailored using quantitative blood flow studies, such as Xe-CT.
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PMID:Intracranial vertebrobasilar artery dissection associated with postpartum angiopathy. 2070 Apr 23

Neurologic complications of post-partum are serious and usually secondary to eclampsia or stroke. We here report a 26-year-old female who presented with severe headaches, blurred vision, and repeated generalized seizures secondary to posterior reversible encephalopathy that occurred after a caesarean section for fetal death in utero. Outcome was favourable. Although uncommon, this neurologic complication of the post-partum should be discussed in the presence of any sign of encephalopathy occurring in the context of acute hypertension.
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PMID:[Unusual leukoencephalopathy of post-partum]. 2088 89

Posterior Reversible Encephalopathy Syndrome (PRES) is a syndrome comprising headache, altered mentation, and seizures, associated with neuroimaging findings characteristic of subcortical edema in the posterior regions. It is usually seen in patients treated with immunosuppressants, in renal failure, or with eclampsia. Recurrent episodes of PRES in the same patient are rarely observed. Although seizures are often seen in PRES, EEG findings are not well described and include generalized and focal slowing with epileptiform discharges; there are limited reports of Periodic Lateralized Epileptiform Discharges (PLEDs) occurring during PRES, and there are no reports of PRES associated with PLEDs with subsequent development of epilepsy. We report a patient we followed for one year with recurrent episodes of PRES associated with posteriorly dominant independent bilateral PLEDs who subsequently developed epilepsy. Patients with PRES and PLEDs should be treated aggressively with anti-hypertensive and anti-epileptic agents in order to avoid potential complications. Although PRES is typically thought of as a reversible syndrome, this case illustrates that PRES may have serious long term sequelae after the reversible syndrome has resolved. This case highlights the importance of aggressive management of PRES as well as the prevention of subsequent episodes of PRES as patients may develop permanent brain dysfunction.
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PMID:Development of chronic epilepsy after recurrent episodes of posterior reversible encephalopathy syndrome associated with periodic lateralized epileptiform discharges. 2111 71

A young woman without any significant medical history received an epidural analgesia for labour. She suddenly presented headache, vision loss, nausea and arterial hypertension a few minutes after a 4-ml ropivacaine 0.75% bolus. The catheter was withdrawn and symptoms completely disappeared within 15 minutes. A new epidural catheter was inserted. Thereafter, the patient gave birth to a healthy newborn infant. Half an hour later, while the epidural catheter was still infusing, she presented generalized tonicoclonic seizure. Potential diagnoses were systemic toxicity of local anaesthetics and eclampsia. Accordingly, the patient received intravenous lipid emulsion and magnesium sulphate. There was no biological abnomabilities. A final diagnosis of posterior reversible encephalopathy syndrome was made with MRI showing bilateral hyperintensity areas involving the cortex of the occipital and frontal areas asymmetrically. On the sixth day, after delivery, the patient was discharged seizure-free. Repeated MRI 4 weeks after discharge was unremarkable.
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PMID:[Epidural analgesia is not the only cause of peripartum central neurologic symptoms. Report of one case of posterior reversible encephalopathy syndrome]. 2114 52


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