An association between vitamin C deficiency and PRES has not been previously described and warrants further study as a potential additional risk factor and target for treatment of PRES.

PRES is an acute neurological disorder characterized by reversible vasogenic cerebral edema with a predilection for posterior subcortical parieto-occipital regions. It is hypothesized to occur due disrupted cerebrovascular autoregulation and endothelial dysfunction. Diagnosis is made based on a combination of acute neurological symptoms, focal vasogenic edema on neuroimaging (typically MRI), and clinical or radiologic reversibility.

Vitamin C plays a role in cardiovascular health due pleiotropic effects on collagen synthesis, antioxidation and nitric oxide bioavailability/function. Vitamin C supplementation reduces biomarkers of inflammation and endothelial injury. Meta analyses demonstrate significant improvements in endothelial function with vitamin C supplementation with a dose-response relation in patients with endothelial dysfunction. In addition, vitamin C stimulates hypoxia-inducible family oxidases and prevents downstream endothelial dysfunction and pulmonary hypertension.