Optic pathway involvement in the posterior reversible encephalopathy syndrome: A case report and review of the literature

• Published in: Radiology case reports Vol. 18; no. 10; pp. 3769 - 3772
• Main Authors: Fujii, Nana, Fujii, Hiroyuki, Matsuki, Mitsuru, Doi, Shugo, Isozaki, Takenori, Watanabe, Yuriko, Nakamata, Akihiro, Fujita, Akifumi, Mori, Harushi
• Format: Journal Article
• Language: English
• Published: Elsevier 01-10-2023
• Subjects: Case Report; Magnetic resonance imaging; Optic pathway; Posterior reversible encephalopathy syndrome
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2023.08.003

Posterior reversible encephalopathy syndrome (PRES) is a clinico-radiological condition characterized by reversible vasogenic edema of the white matter and acute neurological symptoms. PRES typically affects the parieto-occipital regions but rarely affects the optic pathway. Herein, we describe a case of central-variant PRES in a 57-year-old man with abnormal signal intensities in the optic pathway on magnetic resonance imaging (MRI). The patient underwent hemodialysis, initiated diuretics and antihypertensive medications, and the abnormal signal intensities of the brainstem and optic pathway on MRI improved. Although rare, PRES can affect the optic pathway, thus suggesting the possibility of fragility of the optic pathway itself to hyperperfusion.