Dados do Trabalho

Título

Posterior Reversible Encephalophaty Syndrome (PRES): A case report in a male patient from the North’s inner

RESUMO

Case Presentation: E. B. D. S., a 50-year-old, brown male patient, born and resident in the interior of the Amazonas, was admitted in July 2021 with a history of generalized tonic-clonic seizure preceded by occipital pulsating headache events and sudden loss of visual acuity without pain on eye mobilization. He was referred to the capital emergency department with psychomotor agitation and mental confusion after more than 48 hours of the ictus. Brain Magnetic Ressonance Imaging (MRI) was performed and showed signal alteration of the subcortical white matter bilaterally in the occipital lobes, which indicated the possibility of reversible posterior encephalopathy (PRES). Previous commemoratives of note included Systemic Arterial Hypertension (SAH) that was difficult to control, diagnosed during hospitalization, and diabetic nephropathy. After discharge in August, the patient was oriented to drug treatment combined with outpatient neurological and nephrological follow-up; however, geographic and socioeconomic obstacles interrupted follow-up’s consistency.Discussion:PRES is a clinical-radiological entity associated with a wide array of clinical presentations including visual disturbances, headache, seizures and altered mental status.There is no single mechanism that explains the development of PRES in all cases, and multiple nonexclusive mechanisms likely contribute. Hypertension is the most common precipitating factor, with endothelial dysfunction playing an important role. The cerebral imaging abnormalities are often symmetric and predominate in the posterior white matter. The combination of suggestive clinical manifestations and radiological criteria establishes the diagnosis of PRES. Final Comments: The national incidence for Pres is uncertain. Searching main databases, there is an evident discrepancy in the described cases’ scarcity in the north compared to other regions. The interior is a needness' portrait enhanced by obstacles from lack of integration beetween services which provide proper diagnosis, treatment, and especially follow-up care for this neurological disorder, as in this case report.

Palavras Chave

PRES; North's inner; systemic arterial hypertension