Advanced

AJNR - American Journal of Neuroradiology

Published ahead of print on February 13, 2008
doi: 10.3174/ajnr.A0960

This Article Abstract Full Text Full Text (PDF) Supplemental Online Table Alert me when this article is cited Alert me if a correction is posted Citation Map Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Bartynski, W.S. Articles by Marsh, J.W. Search for Related Content PubMed PubMed Citation Articles by Bartynski, W.S. Articles by Marsh, J.W.

Posterior Reversible Encephalopathy Syndrome after Solid Organ Transplantation

W.S. Bartynski^a, H.P. Tan^b, J.F. Boardman^a, R. Shapiro^b and J.W. Marsh^b

^a Department of Radiology, Division of Neuroradiology, University of Pittsburgh, Presbyterian University Hospital, Pittsburgh, Pa
^b Thomas E. Starzl Transplantation Institute, University of Pittsburgh, Montifiore University Hospital, Pittsburgh, Pa

View larger version (132K): [in this window] [in a new window]   Fig 1. Patient 1 is a 73-year-old man who developed altered mental status 11 days after orthotopic liver transplant for cholangitis and cirrhosis with blood pressure at toxicity of 140/76 mm Hg. Mild organ rejection was being treated with increased immune suppression (trough tacrolimus level minimally elevated: 21 ng/mL), and intercurrent blood culture results were positive for coagulase-negative Staphylococcus. MR imaging (FLAIR sequence) obtained at toxicity demonstrates cortex and deep WM vasogenic edema in the occipital region bilaterally (open arrows) judged Edema grade 3. Follow-up MR imaging 1 month later demonstrated complete resolution of the vasogenic edema.

View larger version (117K): [in this window] [in a new window]   Fig 2. Patient 21 is a 59-year-old woman who developed altered mental status, loss of consciousness, and severe hypertension (220/100 mm Hg) 17 months after cadaveric renal transplant for hypertension-related chronic renal failure. She was being managed for mild organ rejection just before toxicity. MR imaging (FLAIR sequence) obtained at toxicity demonstrates primarily cortical vasogenic edema in the occipital poles bilaterally (open arrows) judged Edema grade 1. Follow-up MR imaging 3 days later demonstrated resolution of the vasogenic edema.