Original ArticleBlood Pressure Fluctuations in Posterior Reversible Encephalopathy Syndrome
Section snippets
Methods
We identified consecutive cases of PRES from the medical registries and radiology logs of 2 medical centers: Saint Marys Hospital (Mayo Clinic, Rochester, MN) and the University of Minnesota Medical Center (Minneapolis, MN). The study period extended from October 2005 until June 2006. The study protocol was approved by the institutional review boards of both academic centers.
The inclusion criteria for cases to be entered into this study were: 1) a confirmed diagnosis of PRES, defined by the
Results
We identified 25 cases of PRES in hospitalized patients (for reasons other than PRES), 25 controls matched for age and gender, and 25 controls matched for age, gender, and history of HTN. The median age among PRES cases was 54 years (range 31-76) and among controls 54 years (range 32-73). There were 16 women in each of the groups. History of HTN was present in 14 patients (56%) in the PRES group and control group 2. PRES was primarily ascribed to acute HTN in 13 cases (52%). Other predisposing
Discussion
Our findings indicate that hospitalized patients who develop PRES have higher BP than hospitalized controls matched for age, gender, and history of HTN. However, the severity of HTN in PRES cases is variable and not extreme. Furthermore, BP fluctuations before PRES onset are not more common than in other patients with history of HTN.
The pathophysiology of PRES remains incompletely understood. The most commonly held theory postulates that acute HTN exceeding the autoregulatory capacity of the
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