Case of the Month #41 Posterior Reversible Encephalopathy Syndrome (PRES)

As a general rule, patients with PRES make excellent recoveries 

Recovery can take several days 

For a rare few, the syndrome may progress to malignant PRES 

PRES can cause irreversible injury and patients may be left with long term neurological deficits  

Predictors of incomplete recovery: 

• Secondary intracranial haemorrhage  
• Restricted diffusion on MRI, suggestive of cerebral infarction 
• Extensive cerebral oedema [7] 

Patients may have recurrent episodes of PRES, especially if they have a persistent risk factor  

15% mortality [8]