Korean J Neurotrauma.  2017 Oct;13(2):167-170. 10.13004/kjnt.2017.13.2.167.

Posterior Reversible Encephalopathy Syndrome after Head Trauma Surgery in Pediatric Patient without Any Underlying Disease

• Yoon JE
• Lee CY
• Kim HW

• KMID: 2394555
• DOI: http://doi.org/10.13004/kjnt.2017.13.2.167

Abstract

Posterior reversible encephalopathy syndrome (PRES) is a neurological disorder characterized by signs of posterior cerebral edema upon radiographic examination. A 16-year-old girl was involved in motorcycle accident and depressed frontal fracture was presented. She had generalized seizures 3 days after dural repair and fracture reduction. Signal changes was noted on both parietal lobes in the magnetic resonance images and it was completely resolved in 3 months follow-up. We would like to present the case that demonstrated PRES related hypertension after head trauma surgery for cerebrospinal fluid leakage in pediatric patient without any underlying disease.

Keyword

Pediatric patient; Reversible posterior leukoencephalopathy syndrome; Surgery

MeSH Terms

Adolescent
Brain Edema
Cerebrospinal Fluid Leak
Craniocerebral Trauma*
Female
Follow-Up Studies
Head*
Humans
Hypertension
Motorcycles
Nervous System Diseases
Parietal Lobe
Posterior Leukoencephalopathy Syndrome*
Seizures

Figure

• 

  FIGURE 1 (A, B) Computed tomography scan showed comminuted fractures involving outer, inner walls & inter-sinus septum of frontal sinuses with depressed fractures, fractures extending both orbital roofs & medial orbital walls and small contusion on frontal lobe with drowsy consciousness.

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  FIGURE 2 Initial brain magnetic resonance imaging after head injury. (A–C) Initial T2-weighted/T2 fluid-attenuated inversion recovery image presented no other significant lesion except small contusion in posterior temporal area.

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  FIGURE 3 Brain magnetic resonance imaging (MRI) 3 days after the surgery with generalized seizures. (A–C) MRI showed high signal in T2-weighted/T2 fluid-attenuated inversion recovery image, suggesting cerebral edema, involving the subcortical white matter of bilateral frontal, temporal, parietal, and occipital lobes, with few areas of cortical involvement.

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  FIGURE 4 Brain magnetic resonance imaging 3 months after the surgery. The previous edematous lesions were completely disappeared (A–C).

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