1/9
#Morningreport this week @SinaiBmoreIMRes
featured an interesting case by N. walia
A young Pt presenting with pancreatitis - develops complaints of "bilateral vision loss with progressively worsening headaches "
DDx ???
#MedTwitter #Medstudenttwitter
2/9
BP noted to be: BP: 207/117
Exam:
Eyes: EOMI.
Cannot count fingers.
Appreciates some movement on the right which appear as shadows.
Unable to detect static objects
Neuro: Exam normal
3/9
DDx: Vision loss/Headache ??
Giant Cell Arteritis (GCA)
Migraine
Retinal migraine
Hypertensive retinopathy
optic neuritis
Cerebral venous sinus thrombosis
Intracranial hemorrhage
Posterior circulation stroke
Primary CNS vasculitis
etc
4/9
CT HEAD: CT Head WO Contrast: ill-defined hypoattenuation involving predominantly the subcortical white-matter in both parietal and occipital lobes, concerning for PRES
researchgate.net/figure/Posteri…
5/9
The Dx of PRES was made with signs suggestive on MRI:
6/9:
Pathogenesis:
7/9:
Causes & Presentation
8/9
A few Ddx of PRES:
ICH
Subdural/Subarachnoid hemorrhage
Cerebral sinus venous thrombosis
Posterior circulation ischemic or hemorrhagic stroke
thrombosis of the basilar artery
Vasculitis of the CNS
HSV encephalitis
Autoimmune encephalitis
Uremic encephalopathy
Hypoglycemia
9/9
Management:
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