Hemorrhagic Posterior Reversible Encephalopathy – A Case Report and Literature Review

We aim to review the etiological investigation and differential diagnosis of PRES, including viral infectious diseases, considering the current Coronavirus disease 2019 (COVID-19) pandemic. Our case report showed a critical patient with hemorrhagic PRES associated with nephropathy. Posterior reversible encephalopathy syndrome (PRES) is an acute neurological syndrome that can be presented as a variety of symptoms and it is usually associated with hypertension status, sepsis, eclampsia, autoimmune diseases, immunosuppressive therapy, or infectious diseases. Recently, an association between that hemorrhagic PRES and COVID-19 was reported. The mechanism of posterior reversible encephalopathy syndrome (PRES) is unknown, but there are two main theories to explain the vasogenic brain edema. The typical imaging pattern includes brain vasogenic edema located in the subcortical white matter and the cerebral cortex of the parieto-occipital lobes. There is no specific treatment for PRES and it can be reversible if the predisposing cause is identified and controlled.