%0 Journal Article
%T Posterior leukoencephalopathy following repair of an ileocecal anastomosis breakdown: a case report and review of the literature
%A Pascal O Zinn
%A Rivka R Colen
%A Ekkehard M Kasper
%A Clark C Chen
%J Journal of Medical Case Reports
%D 2011
%I BioMed Central
%R 10.1186/1752-1947-5-20
%X We report the case of a 22-year-old Caucasian man who suffered acute onset visual acuity loss four days after an ileocecal anastomosis. A head magnetic resonance imaging scan revealed findings typically associated with posterior reversible leukoencephalopathy syndrome. His symptoms developed in the context of blood pressure parameters that are typically well tolerated in a post-operative setting (150-160/80-90 mmHg). He did not have a history of renal failure or immunosuppression. His symptoms resolved with aggressive blood pressure management.Posterior reversible leukoencephalopathy syndrome can occur in a post-operative setting with blood pressure parameters typically well-tolerated in most post-surgical patients. Timely diagnosis and treatment will minimize the risk of permanent neurologic injury.Posterior reversible leukoencephalopathy syndrome (PRES) refers to a constellation of neurologic symptoms related to temporary white matter changes [1]. Clinically, it is characterized by a constellation of symptoms including the acute onset of headache, nausea, vomiting, visual changes, altered mental status, seizures, and focal neurologic deficits [2]. The most characteristic radiographic feature involves edema of the subcortical white matter in the posterior cerebral parenchyma [1,3]. This syndrome is typically associated with acute onset severe hypertension (>180/110 mmHg) or with the use of immunosuppressive medications [1,4].While extreme cases of PRES may progress to infarction and hemorrhage despite appropriate blood pressure control [3], the neurologic deficits associated with PRES typically resolve with timely blood pressure control or discontinuation of immunosuppression. A failure to recognize this syndrome and initiate the correct treatment can increase the likelihood of permanent neurologic injuries [5]. The importance of recognizing this syndrome is underscored by the fact that the symptoms of PRES often mimic those of bilateral posterior cerebral artery i
%U http://www.jmedicalcasereports.com/content/5/1/20