Abstract

DE LUCA, Silvina et al. Typical and atypical imaging findings of Posterior Reversible Leukoencephalopathy syndrome. Rev. argent. radiol. [online]. 2008, vol.72, n.3, pp.265-269. ISSN 1852-9992.

Purpose: To make a review of the Posterior Reversible Leukoencephalopathy Syndrome making emphasis on atypical imaging findings. Materials and methods: Ten patients (n:10) were studied retrospectively, six of them women and four men of ages between seven and eighty four (mean age: 40.6). The exams were performed with a multislice CT scanner (Siemens Sensation 16, Erlangen, Germany) and two MRI units (Magnetom Symphony 1.5T and Magnetom Impact 1T, Erlangen, germany) between October 2000 and May 2007. Results: Out of ten (n=10) patients evaluated, 40% (n= 4) presented citotoxic edema (DWI hyperintensity), 70% (n= 7) compromise of the anterior circulation, 20% (n= 2) showed haemorrhage, and 10% (n= 1) brainstem involvement. Conclusion: Usual findings in Posterior Reversible Leukoencephalopathy are bilateral T2 and FLAIR hyperintensity in occipital and parietal white matter, without abnormalities in DWI. However, in some cases, other territories can be affected, citotoxic edema or haemorrhage may be present and the affection can be irreversible. These atipical findings are associated with a worse outcome and grater mortality. An appropiate imaging analysis is important to confirm clinical presumption and establish an early therapy.

Keywords : Posterior reversible leukoencephalopathy; Magnetic Resonance Imaging; Hypertensive encephalopathy.

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