Optic pathway involvement in the posterior reversible encephalopathy syndrome: A case report and review of the literature

Nana Fujii, MD; Hiroyuki Fujii, MD, PhD; Mitsuru Matsuki, MD, PhD; Shugo Doi, MD; Takenori Isozaki, MD; Yuriko Watanabe, MD; Akihiro Nakamata, MD; Akifumi Fujita, MD, PhD; Harushi Mori, MD, PhD

Radiology Case Reports (Oct 2023)

Optic pathway involvement in the posterior reversible encephalopathy syndrome: A case report and review of the literature

Nana Fujii, MD,
Hiroyuki Fujii, MD, PhD,
Mitsuru Matsuki, MD, PhD,
Shugo Doi, MD,
Takenori Isozaki, MD,
Yuriko Watanabe, MD,
Akihiro Nakamata, MD,
Akifumi Fujita, MD, PhD,
Harushi Mori, MD, PhD

Affiliations

Nana Fujii, MD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Hiroyuki Fujii, MD, PhD: Department of Radiology, Jichi Medical University, Tochigi, Japan; Corresponding author.
Mitsuru Matsuki, MD, PhD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Shugo Doi, MD: Division of Nephrology, Department of Internal Medicine, Jichi Medical University, Tochigi, Japan
Takenori Isozaki, MD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Yuriko Watanabe, MD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Akihiro Nakamata, MD: Department of Radiology, Jichi Medical University, Tochigi, Japan
Akifumi Fujita, MD, PhD: Department of Radiology, Haga Red Cross Hospital, Tochigi, Japan
Harushi Mori, MD, PhD: Department of Radiology, Jichi Medical University, Tochigi, Japan

Journal volume & issue: Vol. 18, no. 10
pp. 3769 – 3772

Abstract

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Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological condition characterized by reversible vasogenic edema of the white matter and acute neurological symptoms. PRES typically affects the parieto-occipital regions but rarely affects the optic pathway. Herein, we describe a case of central-variant PRES in a 57-year-old man with abnormal signal intensities in the optic pathway on magnetic resonance imaging (MRI). The patient underwent hemodialysis, initiated diuretics and antihypertensive medications, and the abnormal signal intensities of the brainstem and optic pathway on MRI improved. Although rare, PRES can affect the optic pathway, thus suggesting the possibility of fragility of the optic pathway itself to hyperperfusion.

Published in Radiology Case Reports

ISSN: 1930-0433 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Medicine (General): Medical physics. Medical radiology. Nuclear medicine
Website: https://www.sciencedirect.com/journal/radiology-case-reports

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Abstract

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