Intraventricular hemorrhage is a rare finding in patients with the posterior reversible encephalopathy syndrome and generally carries a poor prognosis. We report a unique case of an 18-year-old girl with glomerulonephritis who developed posterior reversible encephalopathy syndrome without hypertension but with a primary intraventricular hemorrhage and subarachnoid blood without demonstrable parenchymal blood. The normotensive presentation of posterior reversible encephalopathy syndrome and intraventricular hemorrhage in association with systemic vasculitis is rare. Our patient had a good initial outcome and was discharged with resolution of her symptoms and signs of raised intracranial pressure.
HefzyHMBartynskiWSBoardmanJFLacomisD. Hemorrhage in posterior reversible encephalopathy syndrome: imaging and clinical features. Am J Neuroradiol. 2009;30(7):1371-1379.
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SharmaAWhitesellRTMoranKJ. Imaging pattern of intracranial hemorrhage in the setting of posterior reversible encephalopathy syndrome. Neuroradiology. 2010;52(10):855-863.
GascoJRangel-CastillaLClarkSFranklinBSatchithanandamLSalinasP. Hemorrhagic stroke with intraventricular extension in the setting of acute posterior reversible encephalopathy syndrome (PRES): case report. Neurocirugia (Astur). 2009;20(1):57-61.
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BartynskiWS. Posterior reversible encephalopathy syndrome, part 1 fundamental imaging and clinical features. Am J Neuroradiol. 2008;29(6):1036-1042.
PirkerAKramerLVollerBLoaderBAuffEPrayerD. Type of edema in posterior reversible encephalopathy syndrome depends on serum albumin levels: an MR imaging study in 28 patients. Am J Neuroradiol. 2011;32(3):527-531.
