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AJNR - American Journal of Neuroradiology

Published ahead of print on October 14, 2008
doi: 10.3174/ajnr.A1337

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American Journal of Neuroradiology 30:755-757, April 2009
© 2009 American Society of Neuroradiology

Case Report
BRAIN

MR Imaging Findings of Medulla Oblongata Involvement in Posterior Reversible Encephalopathy Syndrome Secondary to Hypertension

T.-Y. Chen^a,b, H.-J. Lee^c, T.-C. Wu^a and Y.-K. Tsui^a

^a Department of Radiology, Chi-Mei Foundation Medical Center, Tainan, Taiwan
^b Shu Zen College of Medicine and Management, Luju Kaohsiung Hsien, Taiwan
^c Departments of Radiology and Neuroradiology, University Hospital, University of Medicine and Dentistry of New Jersey, Newark, NJ

Please address correspondence to Tai-Yuan Chen, Department of Radiology, Chi-Mei Foundation Medical Center, 901, Chung Hwa Rd, Yung Kang City, Tainan, Taiwan; e-mail: 920903{at}mail.chimei.org.tw

SUMMARY: Although the combination of MR imaging findings and clinical evidence of hypertension may suggest the diagnosis of posterior reversible encephalopathy syndrome (PRES), MR imaging findings with only involvement of the medulla oblongata pose a diagnostic dilemma. In the cases presented here, we demonstrated MR imaging findings of a presumed brain stem (medulla oblongata) variant of PRES and emphasized the diagnostic value of diffusion-weighted imaging (DWI).