International Journal of Clinical & Medical Images

Clinical Image

The presssyndrome is a clinico-radiological entityfirst described in 1996 byHincheyet alresponsible for unspecific neurological manifestations, such as confusion, convulsions or visual disturbances. The diagnosis is evoked by brain magnetic resonance imaging (MRI), which shows typically bilateral and symmetrical lesions of the parieto-occipital lobes, as hyperintensities in T2 and fluid-attenuated inversion recovery (FLAIR)sequencessuggestive of vasogenic edema. (Figure 1) Reversibilityis both clinical and radiological, with improvement or disappearance of the white matter hypersignal usually within 15 days. In the most severe forms, ischemic complications may occur, leaving irreversible lesions. Although the pathophysiology is not fully understood. Recently there have been increased reports of PRES induced by several chemotherapeutic agents. The differential diagnoses of PRES are ischemic stroke and cerebral venous thrombosis, infectious encephalitis, para-neoplastic encephalitis or progressive multifocal leukoencephalitis. An early and adapted management usually allows preventing the occurrence of irreversible sequelae.

Keywords: Press syndrome; Chemotherapy; MRI