case_images: PMC9413191_01
case_images: PMC9413191_02
case_images: FLAIR images at onset. Extensive confluent pontine and middle cerebellar peduncle oedema with effacement of the fourth ventricle. Extensive but less confluent vasogenic oedema was seen in the supratentorial brain, predominantly frontally. FLAIR, fluid-attenuated inversion recovery.
case_images: bmjno-2022-000296f01.jpg
case_images: PMC9413191_02_bmjno-2022-000296f01.jpg
case_images: F1
case_images: Extensive but less confluent vasogenic oedema was seen in the supratentorial brain, predominantly frontally (figure 1).
case_images: DWI, FLAIR and SWI on brain MRI at the onset of PRES. FLAIR: oedema in pontine, middle cerebellar peduncle (lower panel) and supratentorial, predominantly anterior (upper panel). SWI: numerous thalamic, callosal and subcortical white matter micro-haemorrhages. DWI, diffusion-weighted MRI; FLAIR, fluid-attenuated inversion recovery; PRES, posterior reversible encephalopathy syndrome; SWI, susceptibility weighted imaging.
case_images: bmjno-2022-000296f02.jpg
case_images: PMC9413191_02_bmjno-2022-000296f02.jpg
case_images: F2
case_images: Susceptibility weighted imaging (SWI) demonstrated numerous thalamic, callosal and subcortical white matter micro-haemorrhages (figure 2).
case_images: PMC9413191_03
case_images: Follow-up supratentorial and pontocerebellar axial FLAIR images on the 1st, 6th and 14th day of admission. Supratentorial and infratentorial oedema improved over time. FLAIR, fluid-attenuated inversion recovery.
case_images: bmjno-2022-000296f03.jpg
case_images: PMC9413191_03_bmjno-2022-000296f03.jpg
case_images: F3
case_images: FLAIR brain MRI, which was repeated once weekly, showed gradual improvements in the signal hyperintensity (figure 3).