AJDRAJNR - American Journal of Neuroradiology

Publication Preview: Published January 9, 2008

American Journal of Neuroradiology 2008;29:456.

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BRAIN

Delayed CSF Enhancement in Posterior Reversible Encephalopathy Syndrome

B.E. Hamilton and G.M. Nesbit

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.