Synonyms:
Reversible posterior leukoencephalopathy syndrome RPLS
Diagnosis:
CT:
- Hypodensity in affected areas, MRI is better.
MRI:
- T2: Hyperintensity in the occipital and sometimes parietal areas bilaterally. Involves the white matter and sometimes the grey matter. Other affected areas; basal ganglia, cerebellum, brain stem, frontal lobes. Areas usually spared: calcarine cortex, paramedian occipital lobe
- DWI: hyperintense restricted diffusion, ADC: hyperintense initially
- T1 +contrast: enchancement may occur
- MRA: Normal
Clinical:
- Encephalopathy with or without headache or homonymous hemianopsia or hemiparesis
- Hypertension is not required for diagnosis but is often present
Pathology:
- White matter oedema, in some cases microinfarcts and fibrinoid necrosis.