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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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American Journal of Neuroradiology 29:456-457, March 2008
© 2008 American Society of Neuroradiology

Case Report
BRAIN

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

Please address correspondence to Bronwyn E. Hamilton, MD, Mail Code CR 135 Department of Diagnostic Radiology, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239; e-mail: hamiltob{at}ohsu.edu

SUMMARY: We present a case of increased fluid-attenuated inversion recovery signal intensity in the subarachnoid spaces on 6-hour delayed enhanced MR imaging in a patient with posterior reversible encephalopathy syndrome (PRES) in the setting of acute hypertensive encephalopathy. This hyperintensity was believed due to CSF gadolinium enhancement, a finding that would be anticipated in light of the suspected pathogenesis of increased microvascular permeability in PRES.