Posterior reversible encephalopathy syndrome in the pediatric population: a pictorial essay

Abstract Posterior reversible encephalopathy syndrome (PRES) is a rare disease attributed to an increase in blood pressure that exceeds the autoregulatory capabilities of the cerebral vasculature, resulting in brain edema. Although PRES primarily affects adults, the pediatric population is also at risk. Radiologists must be aware of that risk because the imaging features on brain MRI are often atypical, especially in pediatric patients. Over a 6-year period, nine pediatric patients were diagnosed with PRES at our institution. Here, those patients are evaluated retrospectively regarding demographic characteristics, clinical profiles, imaging aspects, and outcomes. In this pictorial essay, we review the typical and atypical imaging findings of PRES in pediatric patients, demonstrating that it should be considered in patients with a clinical profile suggestive of the diagnosis, given that prompt, effective treatment is important for full recovery, thus avoiding major morbidity and mortality in such patients.

后部可逆性脑病综合征（Posterior reversible encephalopathy syndrome, PRES）是一类罕见疾病，其发病机制为血压超出脑血管自身调节能力，进而引发脑水肿。尽管该病主要累及成人群体，但儿科人群同样存在发病风险。由于儿科患者的脑部MRI影像学特征往往不典型，放射科医师需警惕该病的发生。本研究团队在6年时间内于本院确诊9例儿科PRES患者，本文将对这些患者的人口统计学特征、临床资料、影像学表现及预后转归进行回顾性分析。在本篇影像图集式综述中，我们总结了儿科患者PRES的典型与非典型影像学表现，旨在提示临床：对于临床征象符合该病疑似诊断的患者，应将PRES纳入鉴别诊断范畴——鉴于及时有效的治疗是实现完全康复的关键，可有效避免此类患者出现严重致残与死亡。