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Abstract Details

The Overlap of Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome
General Neurology
P2 - Poster Session 2 (8:00 AM-9:00 AM)
6-007
To compare clinical presentation, vascular abnormalities and imaging findings among PRES and RCVS.
Posterior reversible encephalopathy syndrome (PRES) is a clinical syndrome with typical neuroimaging findings of vasogenic cerebral edema in posterior-dominant brain regions. Reversible cerebral vasoconstriction syndrome (RCVS) is diagnosed when there is reversible cerebral vessel narrowing and often with thunderclap headache. The two diseases have overlap in clinical and radiographic features.

We searched patients in electronic health record at a single tertiary center from January 2008 to December 2018. Inclusion criteria was 18 years or older with clinical and radiographic evidence of PRES or RCVS. PRES was diagnosed by clinical presentation and presence of vasogenic edema on radiographic imaging.  RCVS was determined by clinical presentation and transient arterial stenosis. Patient demographics, presenting symptoms, comorbid conditions, and imaging findings were compared between PRES and RCVS populations. Analysis was performed using Fisher’s exact test.
Seventy-four patients with PRES and 24 patients with RCVS met inclusion criteria. The median age and presenting blood pressure did not differ between PRES and RCVS groups. PRES population consisted of fewer females (70%) compared to RCVS (92%, p=0.05).  There was no significant difference in frequency of DWI lesions in PRES (37%) and RCVS (24%, p=0.308). Among patients who had arterial imaging, arterial stenosis was seen in 28% (13/46) of PRES. The occurrence of >50% FLAIR reversibility was more common in PRES (67%) and seen less frequently in RCVS (27%, p=0.008).
There is radiographic overlap between PRES and RCVS. About a quarter of the PRES population had arterial stenosis, while about a quarter of the RCVS group had FLAIR reversibility.
Authors/Disclosures
Meghan Purohit, DO
PRESENTER 		Dr. Purohit has nothing to disclose.
Monica Scarsella, MD Dr. Scarsella has nothing to disclose.
Naresh Mullaguri, MD Dr. Mullaguri has nothing to disclose.
Dinesh V. Jillella, MD (Emory University School of Medicine / Grady Memorial Hospital) Dr. Jillella has nothing to disclose.
Ken Uchino, MD (Cleveland Clinic Foundation) Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Aboott Laboratories, Inc.. Dr. Uchino has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for ACP JOURNAL CLUB. The institution of Dr. Uchino has received research support from NIH.
Dolora R. Wisco, MD (Cleveland Clinic) Dr. Wisco has nothing to disclose.