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Findings

Primarily subcortical vasogenic edema in the occipital, parietal, and posterior frontal lobes

Findings are symmetric

No restricted diffusion

Differential diagnosis

Ischemia

Posterior reversible encephalopathy syndrome

Encephalitis

Venous thrombosis

Demyelinating disorder

Vasculitis

PRES (posterior reversible encephalopathy syndrome)

Vasogenic edema associated with hypertention, eclampsia, cyclosporine/FK-506 neurotoxicity

25 of 106 cases of PRES associated with infection, sepsis, and shock (Bartynski, et. al. AJNR, 27:2179-90)

Usually totally reversible even if there is mild restricted diffusion

Vasospasm may be seen in the involved territories

PRES symptoms

Headache

Altered mental status

Seizure

Vision change