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AJNR - American Journal of Neuroradiology

Published ahead of print on January 9, 2008
doi: 10.3174/ajnr.A0926

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Delayed CSF Enhancement in Posterior Reversible Encephalopathy Syndrome

B.E. Hamilton^a and G.M. Nesbit^a

^a From the Department of Diagnostic Radiology, Oregon Health & Science University, Portland, Ore

View larger version (164K): [in this window] [in a new window]   Fig 1. Axial FLAIR image from the patient's first MR imaging examination demonstrates confluent juxtacortical and deep white matter T2 hyperintensity in the bilateral frontal, posterior parietal, and occipital lobes characteristic for PRES. Note the normal hypointense appearance of subarachnoid space fluid.

View larger version (163K): [in this window] [in a new window]   Fig 2. Axial FLAIR scan obtained 6 hours later than Fig 1 demonstrates new diffuse markedly high signal intensity throughout the subarachnoid spaces (arrows). The patient received a second contrast dose (total, 0.2 mmol/kg) immediately (2 minutes) before this sequence, as part of a concurrently performed dynamic susceptibility contrast-enhanced perfusion study