Reversible posterior leukoencephalopathy or brain tumor--case report

• Published in: Liječnički vjesnik Vol. 132; no. 5-6; pp. 151 - 154
• Main Authors: Ribarić, Branka, Milat, Davorka, Gadze, Zeljka Petelin, Franjić, Jasna, Petravić, Damir
• Format: Journal Article
• Language: Croatian
• Published: Croatia 01-05-2010
• Subjects: Aged; Brain - pathology; Brain Neoplasms - diagnosis; Diagnosis, Differential; Female; Humans; Magnetic Resonance Imaging; Posterior Leukoencephalopathy Syndrome - diagnosis
• ISSN: 0024-3477

Reversible posterior leukoencephalopathy (RPLE) syndrome is clinically associated with headache, altered consciousness, seizures and visual symptoms. On brain magnetic resonance imaging (MRI) there is edema predominantly affecting white matter of the parietooccipital brain regions. Initially, this syndrome was believed to be secondary to hypertension, renal disease, or immunosuppressive therapy. However, it has recently been identified in a wide variety of conditions, including eclampsia, hemolytic-uremic syndrome, connective tissue diseases, malignancies, etc. Authors describe a case of a 72-year-old woman with a history of arterial hypertension, who suddenly developed headache, confusion, left homonymous hemianopsia, and left hemiparesis, associated with high blood pressure. Brain MRI revealed extensive white matter lesion in the right parietal and occipital lobe, splenium corpus callosum and left occipital lobe, suggestive of expansive process. However, after extensive diagnostic work-up, diagnosis of reversible posterior leukoencephalopathy was established, connected with arterial hypertension. At the moment the patient is without neurological symptoms, follow-up brain MRI revealed resolution of white matter lesion.