American Journal of Neuroradiology 2009;30:588.
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American Journal of Neuroradiology
DOI 10.3174/ajnr.A1311
BRAIN
Reversible Encephalopathy after Cardiac Transplantation: Histologic Evidence of Endothelial Activation, T-cell Specific Trafficking, and Vascular Endothelial Growth Factor Expression
From the Departments of Pathology (C.H., R.L.H., S.C.) and Radiology (W.S.B.), Thomas Starzl Transplant Institute (H.P.T.) and Pittsburgh Cancer Institute (S.C.), University of Pittsburgh Medical Center, Pittsburgh, Pa; and Department of Neurosurgery (E.C.-W.), University of Rochester, Rochester, NY.
Please address correspondence to Walter S. Bartynski, MD, Department of Radiology, Division of Neuroradiology, Presbyterian University Hospital, University of Pittsburgh, 200 Lothrop St, D132, Pittsburgh, PA 15213; e-mail: bartynskiws{at}upmc.edu
SUMMARY: Reversible encephalopathy after transplantation is well recognized. The condition is commonly thought to be related to immune suppression, and a characteristic brain imaging pattern is typically recognized with vasogenic edema in the parietal and occipital regions, typically termed posterior reversible encephalopathy syndrome (PRES). We report the case of a patient with reversible encephalopathy after cardiac transplantation with brain biopsy evidence of endothelial activation, selective intravascular/perivascular T-cell trafficking, and VEGF expression in astrocytes, neurons, and the endothelium.
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