PRES is an increasingly recognized clinicoradiologic syndrome caused by dysfunction of the brain capillary endothelium resulting in vasogenic edema mainly in the occipital lobes. The etiologies of PRES include acute hypertension, eclampsia, immunosuppressive therapy and renal disease or following surgical procedures. The main symptoms are related to the visual system including hemianopsia, visual neglect or cortical blindness.
The mechanism behind PRES remains controversial and unproven. Severe hypertension leading to a blood pressure that exceeds the upper limits of autoregulation, with subsequent forced hyperperfusion, has been suggested. Conversely, vasculopathy and hypoperfusion have been reported, and the PRES imaging appearance resembles a watershed distribution. According to our study although patients with PRES syndrome improved significantly in rehabilitation in most of cognitive and ADL functions, they are left with severe visual field disturbances affecting their independence.
Zeev Meiner– Senior Physician, Hadassah Hebrew-University Medical Center
Yonah Ofran– Dr., Hadassah Hebrew-University Medical Center
Elior Moreh– Dr., Hadassah Hebrew-University Medical Center
Jeanna Tsenter– Dr., Hadassah Hebrew-University Medical Center
Isabella Schwartz– Dr, Hadassah Hebrew-University Medical Center