Gülşah KARAÖREN, Elif DEİRMENCİ, İbrahim İKİZCELİ, Hüseyin ÖZ

İNTRAABDOMİNAL SEPSİSE BAĞLI GELİŞEN POSTERİOR REVERSİBL ENSEFALOPATİ SENDROMU OLGUSU

Posterior reversibl ensefalopati sendromu (PRES) baş ağrısı, nöbet, görme kaybından bilinç bozukluğuna kadar gidebilengeri dönüşümlü kliniko-radyolojik bir sendromdur. Etiyolojide, posterior parietal ve oksipital bölgelerde vazojenik ödeme yolaçan arteriyel hipertansiyon, otoimmunite ve metabolik sendromlar gibi çeşitli faltörler rol oynamaktadır. PRES düşünülen hastalardagörüntüleme yöntemlerinden manyetik rezonans ve difüzyon manyetik rezonans anahtar rol oynar. Biz önceden bilinen aileseladenomatöz polipozis tanılı, yakın zamanda geçirilmiş cerrahi sonrası intraabdominal sepsis sebebiyle yoğun bakımda takipedilen 20 yaşındaki olguda gelişen PRES sendromunu sunmayı amaçladık

A CASE OF POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME DUE TO INTRAABDOMINAL SEPSIS

Posterior reversible encephalopathy syndrome (PRES) is a reversible clinico-radiological disorder that can presents itself withheadache, seizures, and visual disturbances up to loss of consciousness. In the etiology, various factors as the arterial hypertension,autoimmunity and metabolic syndromes are the causes, usually associated with vasogenic edema in the posterior parietal andoccipital regions. In patients suspected of PRES syndrome, magnetic resonance and diffusion magnetic resonance imaging playthe key role. This is a case report of a 20-year-old patient with the history of familial adenomatous polyposis who demonstratedPRES syndrome during the treatment of intraabdominal sepsis due to a recent colorectal surgery

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1. Hinchey J, Chavez C, Appignani B, et al. A reversible posterior syndrome. N Eng J Med. 1996; 334: 494-500.
2. Bakshi R, Bates VE, Mechtler LL, Kinkel PR, Kinkel WR. Occipital lobe seizures as the major clinical manifestion of reversible posterior leukoencephalopathy syndrome: magnetic resonance imaging findings. Epilepsia. 1998; 39: 295-299.
3. Yasuda Y, Akiguchi I, Imai T, Sonobe M, Kage M. Hypertensive brainstem encephalopaty. Intern Med. 2003; 42: 1131-1134.
4. Bartynski WS, Boardman JF, Zeigler ZR, Shadduck RK, Lister J. Posterior reversible encephalopathy syndrome in infection, sepsis, and shock. AJNR Am J Neuroradiol 2006; 27: 2179-2190.
5. Honca M, Polat A, Horasanl› E. Kardiyak Arest Geçiren Eklamptik Hastada Geliflen Posterior Reversible Ensefalopati Sendromu; Olgu Sunumu ve Literatürün Gözden Geçirilmesi (Posterior Reversible Encephalopathy Syndrome in an Eclamptic Patient After Cardiac Arrest; Case Report and Literature Review). TARDD 2014; 42: 50-53.
6. Finsterer J, Stöllberger C, Ostermann E, Zuntner G, Huber J, Tscherney R. Recurrent posterior reversibl encephalopaty syndrome in mitochondrial disorder Blood Press 2009; 18: 126-129.
7. Fugate JE, Claassen DO, Cloft HJ, Kallmes DF, Kozak OS, Rabinstein AA. Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. Mayo Clin Proc 2010; 85: 427-432.
8. Ergün T, Lakadamyali H, Y›lmaz A. Recurrent posterior reversible encephalopaty syndrome in a hypertensive patient with end-stage renal disease. Diagn Interv Radiol. 2008; 14: 182-185.
9. Hagemann G, Ugur T, Witte OW, Fitzek C. Reccurrent posterior reversible encephalopathy syndrome (PRES). J Hum Hypertens. 2004; 18: 287-289.
10. Tar›m E, Giray S. Posterior Reversible Encephalopathy Syndrome (PRES) in the Differential Diagnosis of Eclampsia: Case Report (Eklampsinin Ay›r›c› Tan›s›nda Posterior Geri Dönüflümlü Ensefalopati Sendromu.) J Gynecol Obst 2011; 21: 213-215.
11. Zamvar V, Sugarman ID, Tawfik RF, Macmullen J, Puntis JW. Posterior Reversible Encehalopaty Syndrome Following Infliximab Infusion. J Pediatr Gastroenterolo Nutr. 2009; 48: 102-105.
12. O¤uztürk H, Turtay MG, Do¤an M, Gönüllü S, Çelik E. PRES e Ba¤l› Ani Geliflen Bilateral Görme Kayb› (Sudden Bilateral Visual Loss Developed Connected to PRES). Acil T›p Olgu Sunumlar› Dergisi. 2010; 1: 48-50.
13. Teksam M, Casey SO, Michel E, Truwit CL. Posterieor reversibl ensefalopati sendromu: patofizyoloji ve ileri MRG teknikleri ile korelasyon. Tan› Giriflim Radyol 2001; 7: 464-472.
14. Hefzy HM, Bartynski WS, Boardman JF, Lacomis D. Hemorrhage in posterior reversible encephalopathy syndrome: imaging and clinical features. AJNR Am J Neuroradiol 2009; 30: 1371-1379.
15. Bartynski WS, Boardman JF. Catheter angiography, MR angiography, and MR perfusion in posterior reversible encephalopathy syndrome. AJNR Am J Neuroradiol 2008; 29: 447-455.
16. Demirtafl Ö, Gelal F, Vidinli BD, Demirtas LO, Uluc E, Baloglu A. Preeklampsi ve Eklampside Kranial MR Görüntüleme ve Klinik Korelasyon (Cranial MR imaging with clinical correlation in preeclampsia and eclampsia). Diag Interv Radiol 2005; 11: 189-194.