CT perfusion imaging in the management of posterior reversible encephalopathy

A 13-year-old girl with a renal transplant presented with hypertension and seizures. CT and MRI demonstrated typical bilateral parietal, occipital and posterior frontal cortical and subcortical edema, thought to represent posterior reversible encephalopathy syndrome. The cause was presumed to be hyp...

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Veröffentlicht in:Neuroradiology 2004-04, Vol.46 (4), p.272-276
Hauptverfasser: CASEY, S. O, MCKINNEY, A, TEKSAM, M, LIU, H, TRUWIT, C. L
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container_title Neuroradiology
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creator CASEY, S. O
MCKINNEY, A
TEKSAM, M
LIU, H
TRUWIT, C. L
description A 13-year-old girl with a renal transplant presented with hypertension and seizures. CT and MRI demonstrated typical bilateral parietal, occipital and posterior frontal cortical and subcortical edema, thought to represent posterior reversible encephalopathy syndrome. The cause was presumed to be hypertension. Antihypertensive therapy was started, lowering of the blood pressure in the range of 110-120 mmHg systolic. However, stable xenon (Xe) CT perfusion imaging revealed ischemia within the left parietal occipital region. The antihypertensive was adjusted which increased both the systolic and diastolic blood pressure by 31 mm Hg. The patient was re-imaged with Xe CT and was found to have resolution of the ischemic changes within the left parietal occipital region. In this report, we present a case in which stable Xe CT was used to monitor the degree of cerebral perfusion and guide titration of antihypertensive therapy. Such brain perfusion monitoring may have helped to prevent infarction of our patient.
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subjects Adolescent
Antihypertensive Agents - therapeutic use
Biological and medical sciences
Brain Diseases - diagnostic imaging
Brain Edema - etiology
Brain Ischemia - diagnostic imaging
Children & youth
Female
Humans
Hypertension - complications
Investigative techniques, diagnostic techniques (general aspects)
Kidney Transplantation
Magnetic Resonance Imaging
Medical imaging
Medical sciences
Nervous system
Neurology
Parietal Lobe - blood supply
Parietal Lobe - diagnostic imaging
Radiodiagnosis. Nmr imagery. Nmr spectrometry
Radiology
Seizures - etiology
Tomography, X-Ray Computed
Xenon
title CT perfusion imaging in the management of posterior reversible encephalopathy
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