A Case Report of Hypertensive Retinopathy Combined with Posterior Reversible Encephalopathy Syndrome

doi:10.3969/j.issn.1673-5765.2024.11.007

Chinese Journal of Stroke ›› 2024, Vol. 19 ›› Issue (11): 1301-1305.DOI: 10.3969/j.issn.1673-5765.2024.11.007

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A Case Report of Hypertensive Retinopathy Combined with Posterior Reversible Encephalopathy Syndrome

LU Qingli, LIU Pei, SUN Chao, SHI Yaling, LIN Xuemei, WU Songdi

Department of Neurology and Neuro-Ophthalmology, The First Hospital of Xi’an (The First Affiliated Hospital of Northwest University), Xi’an Key Laboratory for Innovation and Translation of Neuroimmunological Diseases, Xi’an 710002, China

Received:2024-08-28 Online:2024-11-20 Published:2024-11-20
Contact: WU Songdi wusongdi@gmail.com

高血压性视网膜病变合并可逆性后部脑病综合征1例报道

逯青丽，刘佩，孙超，史亚玲，蔺雪梅，吴松笛

西安 710002 西安市第一医院（西北大学附属第一医院）神经内科和神经眼科，西安市神经免疫疾病创新转化重点实验室

通讯作者: 吴松笛 wusongdi@gmail.com
基金资助:
陕西省重点研发计划项目（2022SF-381；2022SF-507；2023-YBSF-048；2023-YBSF-052）
陕西省中医药管理局项目（2022-SLRH-LJ-013）
西安市科技计划项目（22YXYJ0074；23YXYJ0055；23YXYJ0060；23YXYJ0005；24YXYJ0089）

Abstract

Abstract: Retinopathy is one of the common complications of hypertension, but the combination of posterior reversible encephalopathy syndrome (PRES) is rarely reported. This paper reported a 34-year-old male patient, presenting with blurred vision and headache as the main symptoms. The visual acuity and intraocular pressure were normal. Fundus examination of both eyes revealed flame-shaped retinal hemorrhage and cotton wool spots, leading to a diagnosis of hypertensive retinopathy. Blood pressure was 230/150 mmHg (1 mmHg=0.133 kPa) measured in the clinic, and cranial MRI FLAIR sequence showed multiple patchy hyperintensity in both cerebral hemispheres and brain stem. Aside from renal injury, serological and cerebrospinal fluid tests showed no abnormalities. After aggressive antihypertensive therapy, the clinical symptoms and cranial imaging signs of the patient were improved, and the final clinical diagnosis was PRES.

Key words: Hypertensive retinopathy; Posterior reversible encephalopathy syndrome; Antihypertensive therapy

摘要： 视网膜病变是高血压常见并发症之一，但同时合并可逆性后部脑病综合征少有报道。本文报道1例34岁男性患者，以视物模糊、头痛为主要表现，视力、眼压正常，双眼眼底检查显示火焰状视网膜出血和棉絮斑，诊断为高血压性视网膜病变。门诊测血压230/150 mmHg（1 mmHg=0.133 kPa），头颅MRI FLAIR序列示双侧大脑半球及脑干多发斑片状高信号。除肾损害外，血清学和脑脊液检查未见异常。积极予以降血压治疗后，患者临床症状和头颅影像学征象均改善，最终临床诊断为可逆性后部脑病综合征。

关键词: 高血压性视网膜病变; 可逆性后部脑病综合征; 降血压治疗

CLC Number:

LU Qingli, LIU Pei, SUN Chao, SHI Yaling, LIN Xuemei, WU Songdi. A Case Report of Hypertensive Retinopathy Combined with Posterior Reversible Encephalopathy Syndrome[J]. Chinese Journal of Stroke, 2024, 19(11): 1301-1305.

逯青丽, 刘佩, 孙超, 史亚玲, 蔺雪梅, 吴松笛. 高血压性视网膜病变合并可逆性后部脑病综合征1例报道[J]. 中国卒中杂志, 2024, 19(11): 1301-1305.

References

[1] CHEUNG C Y，BIOUSSE V，KEANE P A，et al. Hypertensive eye disease[J/OL]. Nat Rev Dis Primers，2022，8（1）：14[2024-07-22]. https://doi.org/10.1038/s41572-022-00342-0.
[2] WONG T Y，MITCHELL P. Hypertensive retinopathy[J]. N Engl J Med，2004，351（22）：2310-2317.
[3] FRASER-BELL S，SYMES R，VAZE A. Hypertensive eye disease：a review[J]. Clin Exp Ophthalmol，2017，45（1）：45-53.
[4] MISHIMA E，FUNAYAMA Y，SUZUKI T，et al. Concurrent analogous organ damage in the brain，eyes，and kidneys in malignant hypertension：reversible encephalopathy，serous retinal detachment，and proteinuria[J]. Hypertens Res，2021，44（1）：88-97.
[5] HINCHEY J，CHAVES C，APPIGNANI B，et al. A reversible posterior leukoencephalopathy syndrome[J]. N Engl J Med，1996，334（8）：494-500.
[6] FUGATE J E，RABINSTEIN A A. Posterior reversible encephalopathy syndrome：clinical and radiological manifestations，pathophysiology，and outstanding questions[J]. Lancet Neurol，2015，14（9）：914-925.
[7] TOLEDANO M，FUGATE J E. Posterior reversible encephalopathy in the intensive care unit[J/OL]. Handb Clin Neurol，2017，141：467-483[2024-07-22]. https://doi.org/10.1016/B978-0-444-63599-0.00026-0.
[8] OLLIVIER M，BERTRAND A，CLARENÇON F，et al. Neuroimaging features in posterior reversible encephalopathy syndrome：a pictorial review[J/OL]. J Neurol Sci，2017，373：188-200[2024-07-22]. https://doi.org/10.1016/j.jns.2016.12.007.
[9] MCKINNEY A M，JAGADEESAN B D，TRUWIT C L. Central-variant posterior reversible encephalopathy syndrome：brainstem or basal ganglia involvement lacking cortical or subcortical cerebral edema[J]. AJR Am J Roentgenol，2013，201（3）：631-638.
[10] HINDUJA A. Posterior reversible encephalopathy syndrome：clinical features and outcome[J/OL]. Front Neurol，2020，11：71[2024-07-22]. https://doi.org/10.3389/fneur.2020.00071.
[11] KASTRUP O，SCHLAMANN M，MOENNINGHOFF C，et al. Posterior reversible encephalopathy syndrome：the spectrum of MR imaging patterns[J]. Clin Neuroradiol，2015，25（2）：161-171.
[12] GOWAN J M，LIU A. Isolated pan-pontine posterior reversible encephalopathy syndrome in a patient with uncontrolled hypertension[J]. Clin Case Rep，2018，7（1）：32-36.

A Case Report of Hypertensive Retinopathy Combined with Posterior Reversible Encephalopathy Syndrome

高血压性视网膜病变合并可逆性后部脑病综合征1例报道

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