Purpose of Review

This review provides an updated discussion on the clinical presentation, diagnosis and radiographic features, mechanisms, associations and epidemiology, treatment, and prognosis of posterior reversible encephalopathy syndrome (PRES). Headache is common in PRES, though headache associated with PRES was not identified as a separate entity in the 2018 International Classification of Headache Disorders. Here, we review the relevant literature and suggest criteria for consideration of its inclusion.

Recent Findings

COVID-19 has been identified as a potential risk factor for PRES, with a prevalence of 1–4% in patients with SARS-CoV-2 infection undergoing neuroimaging, thus making a discussion of its identification and treatment particularly timely given the ongoing global pandemic at the time of this writing.

Summary

PRES is a neuro-clinical syndrome with specific imaging findings. The clinical manifestations of PRES include headache, seizures, encephalopathy, visual disturbances, and focal neurologic deficits. Associations with PRES include renal failure, preeclampsia and eclampsia, autoimmune conditions, and immunosuppression. PRES is theorized to be a syndrome of disordered autoregulation and endothelial dysfunction resulting in preferential hyperperfusion of the posterior circulation. Treatment typically focuses on treating the underlying cause and removal of the offending agents.

中文翻译：

---

后可逆性脑病综合征

审查目的

这篇综述提供了关于后可逆性脑病综合征（PRES）的临床表现，诊断和影像学特征，机制，关联和流行病学，治疗和预后的最新讨论。头痛在PRES中很常见，尽管与PRES相关的头痛在2018年《国际头痛分类》中没有被确定为单独的实体。在这里，我们回顾了相关文献并提出了考虑纳入的标准。

最近的发现

COVID-19已被确定为PRES的潜在危险因素，接受神经影像学检查的SARS-CoV-2感染患者的患病率为1-4％，因此，鉴于持续的全球大流行，特别是及时讨论其鉴定和治疗在撰写本文时。

概括

PRES是一种具有特定影像学发现的神经临床综合征。PRES的临床表现包括头痛，癫痫发作，脑病，视力障碍和局灶性神经功能缺损。与PRES的关联包括肾衰竭，先兆子痫和子痫，自身免疫性疾病和免疫抑制。从理论上讲，PRES是自体调节紊乱和内皮功能障碍的综合症，可导致后循环优先灌注过多。治疗通常着重于治疗根本原因和清除有害物质。