Display options
Cite
Hansberry DR, Agarwal N, Tomei KL, et al. Posterior reversible encephalopathy syndrome in a patient with a Chiari I malformation. Surg Neurol Int. 2013;4:130doi: 10.4103/2152-7806.119076.
Hansberry, D. R., Agarwal, N., Tomei, K. L., & Goldstein, I. M. (2013). Posterior reversible encephalopathy syndrome in a patient with a Chiari I malformation. Surgical neurology international, 4130. https://doi.org/10.4103/2152-7806.119076
Hansberry, David R, et al. "Posterior reversible encephalopathy syndrome in a patient with a Chiari I malformation." Surgical neurology international vol. 4 (2013): 130. doi: https://doi.org/10.4103/2152-7806.119076
Hansberry DR, Agarwal N, Tomei KL, Goldstein IM. Posterior reversible encephalopathy syndrome in a patient with a Chiari I malformation. Surg Neurol Int. 2013 Sep 30;4:130. doi: 10.4103/2152-7806.119076. eCollection 2013. PMID: 24232171; PMCID: PMC3814995.
Copy Download .nbib Format: NLM
Share it on

Surg Neurol Int. 2013 Sep 30;4:130. doi: 10.4103/2152-7806.119076. eCollection 2013.

Posterior reversible encephalopathy syndrome in a patient with a Chiari I malformation.

Surgical neurology international

David R Hansberry, Nitin Agarwal, Krystal L Tomei, Ira M Goldstein

Affiliations

  1. Department of Neurological Surgery, Rutgers New Jersey Medical School, Newark, New Jersey, USA.

PMID: 24232171 PMCID: PMC3814995 DOI: 10.4103/2152-7806.119076

Abstract

BACKGROUND: The authors describe a unique case of a patient who developed posterior reversible encephalopathy syndrome (PRES) following postoperative treatment of a Chiari I malformation.

CASE DECSRIPTION: A 25-year-old female presented with complaints of left upper and lower extremity paresthesias and gait disturbances. A magnetic resonance imaging (MRI) of the brain and cervical spine showed a Chiari I malformation with tonsillar descent beyond the level of the C1 lamina. She underwent a suboccipital craniectomy and C1 laminectomy with cerebellar tonsillar cauterization and duraplasty. Postoperatively, an MRI showed bilateral acute infarcts of the cerebellar vermis. She was initially treated for cerebellar ischemia with hypertensive therapy with a subsequent decline in her neurologic status and generalized tonic-clonic seizure. Further workup showed evidence of PRES. After weaning pressors, the patient had a significant progressive improvement in her mental status.

CONCLUSION: Although the mechanism of PRES remains controversial given its diverse clinical presentation, several theories implicate hypertension and steroid use as causative agents.

Keywords: Chiari I malformation; cerebellar tonsillar resection; posterior reversible encephalopathy syndrome; pressors; suboccipital craniectomy

References

  1. Neurosurgery. 1994 Aug;35(2):214-23; discussion 223-4 - PubMed
  2. Pediatr Neurosurg. 2007;43(5):386-95 - PubMed
  3. Lancet. 1994 Nov 12;344(8933):1335-8 - PubMed
  4. AJNR Am J Neuroradiol. 2000 Aug;21(7):1199-206 - PubMed
  5. Neurosurgery. 1995 Apr;36(4):854-7 - PubMed
  6. Childs Nerv Syst. 2011 Sep;27(9):1361-3 - PubMed
  7. Pediatr Neurosurg. 1990-1991;16(1):25-31; discussion 31 - PubMed
  8. AJNR Am J Neuroradiol. 2008 Jun;29(6):1043-9 - PubMed
  9. J Neurosurg. 1983 Feb;58(2):183-7 - PubMed
  10. Brain Dev. 2006 Sep;28(8):544-6 - PubMed
  11. AJR Am J Roentgenol. 1992 Aug;159(2):379-83 - PubMed
  12. Curr Opin Ophthalmol. 2008 Nov;19(6):479-84 - PubMed
  13. Clin Neurol Neurosurg. 1997 Aug;99(3):222-6 - PubMed
  14. Intensive Care Med. 2007 Feb;33(2):230-6 - PubMed
  15. J Neurosurg Pediatr. 2011 Aug;8(2):177-83 - PubMed
  16. AJR Am J Roentgenol. 1995 Sep;165(3):627-31 - PubMed
  17. Neurosurgery. 1999 May;44(5):1005-17 - PubMed
  18. J Neuroimaging. 2011 Jul;21(3):219-24 - PubMed
  19. Cortex. 1998 Apr;34(2):279-87 - PubMed
  20. AJNR Am J Neuroradiol. 2006 Nov-Dec;27(10):2179-90 - PubMed
  21. Clin Infect Dis. 2001 Jan 15;32(2):236-42 - PubMed
  22. Bone Marrow Transplant. 2010 Apr;45(4):779-80 - PubMed
  23. Semin Neurol. 2011 Apr;31(2):202-15 - PubMed
  24. J Neurosurg Pediatr. 2011 Nov;8(5):430-7 - PubMed
  25. World Neurosurg. 2011 Feb;75(2):307-13 - PubMed
  26. Childs Nerv Syst. 2005 Mar;21(3):234-6 - PubMed
  27. Childs Nerv Syst. 2011 Jan;27(1):35-40 - PubMed
  28. Indian J Pediatr. 2011 Aug;78(8):1002-4 - PubMed
  29. Childs Nerv Syst. 1998 Sep;14(9):460-2 - PubMed
  30. Arch Neurol. 2008 Feb;65(2):205-10 - PubMed
  31. Neurosurgery. 1983 Apr;12(4):377-90 - PubMed
  32. AJNR Am J Neuroradiol. 1991 Jul-Aug;12(4):651-9 - PubMed
  33. Int Rev Neurobiol. 1997;41:411-32 - PubMed
  34. J Neurosurg. 2002 Mar;96(3):607-10 - PubMed
  35. Radiographics. 1998 Mar-Apr;18(2):353-67 - PubMed
  36. Br J Neurosurg. 2001 Feb;15(1):47-50 - PubMed
  37. AJNR Am J Neuroradiol. 2008 Jun;29(6):1036-42 - PubMed
  38. Postgrad Med J. 2001 Jan;77(903):24-8 - PubMed
  39. Neurology. 1999 Oct 12;53(6):1372-3 - PubMed
  40. Pediatr Neurol. 1997 Apr;16(3):218-9 - PubMed
  41. N Engl J Med. 1996 Feb 22;334(8):494-500 - PubMed

Publication Types