A Lesser Known Stroke Mimic: Posterior Reversible Encephalopathy Syndrome

Posterior reversible encephalopathy syndrome (PRES) is a clinico-neuro-radiological diagnosis, which can complicate a wide range of conditions. Clinical features include generalised and/or focal neurological deficits. These features are also present in neurovascular disorders, such as stroke. Currently, emphasis in the management of hyperacute stroke is thrombolysis, and it is important to bear in mind stroke mimics as a possible cause of clinical features. The Authors present the case of a 66-year-old man, who presented with acute focal neurological deficit. His brain imaging and history were consistent with PRES. LEARNING POINTS: Posterior reversible encephalopathy syndrome (PRES) should be considered as a possibility in hyperacute stroke, especially those with posterior cerebral symptoms and signs. Serial CT brain scanning may be helpful when MRI is unavailable or contraindicated. Early recognition and management of this syndrome would prevent permanent brain damage and unnecessary investigations and treatments.