Posterior reversible encephalopathy syndrome: An emerging clinical entity in adult, pediatric, and obstetric critical care
Version of Record online: 7 FEB 2008
2008 The Author(s) Journal compilation
Journal of the American Academy of Nurse Practitioners
Volume 20, Issue 2, pages 100–106, February 2008
How to Cite
McCoy, H. O. (2008), Posterior reversible encephalopathy syndrome: An emerging clinical entity in adult, pediatric, and obstetric critical care. Journal of the American Academy of Nurse Practitioners, 20: 100–106. doi: 10.1111/j.1745-7599.2007.00292.x
- Issue online: 7 FEB 2008
- Version of Record online: 7 FEB 2008
- Received: January 2007; accepted: April 2007
- Posterior reversible encephalopathy syndrome, PRES;
- hypertensive encephalopathy;
Purpose: To describe the signs, symptoms, causative factors, and treatment for posterior reversible encephalopathy syndrome (PRES), an emerging clinical neuroradiologic entity which may be encountered by nurse practitioners in almost any clinical setting.
Data sources: Extensive review of worldwide literature, including peer-reviewed medical specialty journals, supplemented by an actual case study. Currently, a paucity of information exists in the nursing literature.
Conclusions: PRES occurs as a result of disordered cerebral circulatory autoregulation and/or endothelial dysfunction, usually as a result of acute, intermittent hypertension. Clinical manifestations include mental status change, headache, visual disturbance, and seizures. Characteristic abnormalities in the posterior cerebral white matter, seen best on diffusion-weighted magnetic resonance imaging, confirm the presence of the syndrome. PRES has been documented worldwide among a diverse patient population, yet many clinicians are still unfamiliar with this diagnosis.
Implications for practice: PRES is a clinical-radiographic diagnosis that requires close collaboration between the clinician and interpreting radiologist. Rapid identification and appropriate diagnostics are essential, as prompt treatment usually results in reversal of symptoms; permanent neurologic injury or death can occur with treatment delay.