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We presented a case of PRES with CSF hypovolemia as a result of an inadvertent dural puncture and reviewed the literature to identify the clinical characterization and pathophysiological mechanism of PRES following CSF hypovolemia. A total of 41 cases with a notable female predominance (87.1%). Fifteen patients (48.4%) didnt have cause of CSF hypovolemia was epidural or lumbar puncture (n=21), followed by CSF shunt (n=6). The median interval between the procedure leading to CSF hypovolemia and PRES was 4 days. Seizure, altered mental state, and headache were the most frequent presenting symptom. The parieto-occipital pattern was most frequent (71.0%). Conservative management remains the mainstay of treatment with excellent outcomes. Three patients had a second episode of PRES. Given that CSF hypovolemia is a common complication of anesthetic, neurological, and neurosurgical procedures, PRES should be early considered for prompt diagnosis and appropriate management. |
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anesthesia,spinal
cerebrospinal fluid,hypovolemia
cerebrospinal fluid,leak
complications
epidural blood patch
fever of unknown origin
gender
headache
iatrogenic neurologic disorders
intracranial hypotension
lumbar puncture
lumbar puncture,complications of
mental status,abnormal
MRI,abnormal
posterior leukoencephalopathy syndrome
precipitating factors
primary intracranial hypotension
seizure
shunt procedure,lumboperitoneal
shunt procedure,ventricular
shunt procedure,ventricular-complications of
treatment of neurologic disorder
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