Emergency Brain MRI: Recognizing PRES Before Permanent Neurological Injury

 Introduction

When Minutes Determine Whether Brain Injury Is Reversible

A previously healthy 36-year-old woman suddenly developed a severe headache while at work. Within a short period, she experienced blurred vision, generalized tonic-clonic seizures, and progressive confusion. On arrival at the emergency department, her blood pressure exceeded 220/120 mmHg.

The emergency physician immediately considered several neurological emergencies, including acute ischemic stroke, intracranial hemorrhage, cerebral venous thrombosis, encephalitis, and hypertensive encephalopathy.

A non-contrast brain CT was rapidly performed. Although no intracranial hemorrhage was identified, subtle bilateral hypodense lesions were noted within the parieto-occipital white matter. These findings prompted immediate MRI evaluation.

Magnetic Resonance Imaging demonstrated symmetric vasogenic edema involving both parieto-occipital lobes. Diffusion-weighted imaging revealed no evidence of restricted diffusion, effectively excluding acute cerebral infarction. The imaging findings, combined with the patient's clinical presentation, confirmed the diagnosis of Posterior Reversible Encephalopathy Syndrome (PRES).

Following aggressive blood pressure control and supportive treatment, the patient's neurological symptoms gradually resolved. Follow-up MRI demonstrated near-complete resolution of the cerebral edema, highlighting the reversible nature of this syndrome when recognized early.

This clinical scenario emphasizes one of the most important principles in emergency neuroradiology:

PRES is potentially reversible—but only if it is diagnosed promptly.

As emergency departments become increasingly overwhelmed with neuroimaging studies, artificial intelligence (AI), deep learning algorithms, and Clinical Decision Support Systems (CDSS) are emerging as valuable tools that may reduce diagnostic delays and improve patient outcomes.

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Why PRES Has Become Increasingly Important

Posterior Reversible Encephalopathy Syndrome is no longer considered a rare neurological disorder. The widespread use of MRI has significantly increased recognition of this syndrome over the past two decades.

Modern healthcare systems now encounter PRES in numerous clinical settings, including:

• Hypertensive emergencies
• Preeclampsia and eclampsia
• Autoimmune diseases
• Chemotherapy-associated neurotoxicity
• Organ transplantation
• Immunosuppressive therapy
• Sepsis
• Acute kidney injury
• Systemic inflammatory disorders

Because the neurological symptoms are often nonspecific, imaging plays a decisive role in establishing the diagnosis.

Failure to recognize PRES may result in:

• Permanent neurological disability
• Intracranial hemorrhage
• Cerebral infarction
• Increased intensive care admissions
• Higher mortality

Conversely, early diagnosis combined with prompt treatment frequently leads to complete neurological recovery.

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Clinical Background

Understanding Posterior Reversible Encephalopathy Syndrome

Posterior Reversible Encephalopathy Syndrome is a clinicoradiological disorder characterized by acute neurological dysfunction associated with vasogenic cerebral edema.

Unlike ischemic stroke, which results from irreversible neuronal infarction caused by vascular occlusion, PRES primarily reflects disruption of the blood-brain barrier secondary to endothelial dysfunction and impaired cerebral autoregulation.

The resulting extracellular accumulation of fluid produces vasogenic edema that predominantly affects the posterior cerebral circulation.

This predilection for posterior brain regions is believed to reflect relatively reduced sympathetic innervation within the vertebrobasilar circulation, rendering these territories more vulnerable to abrupt increases in blood pressure.

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Pathophysiology

Current evidence suggests that multiple mechanisms contribute to PRES development.

Severe Hypertension

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Endothelial Dysfunction

Patients receiving chemotherapy, calcineurin inhibitors, or immunotherapy may develop endothelial injury even in the absence of severe hypertension.

Common associated conditions include:

• Tacrolimus toxicity
• Cyclosporine therapy
• Bevacizumab treatment
• Sepsis-associated inflammation
• Systemic lupus erythematosus
• Renal failure

These mechanisms demonstrate why PRES should be considered a systemic vascular disorder rather than merely a hypertensive complication.

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Clinical Presentation

Symptoms usually develop within hours but occasionally evolve over several days.

Typical manifestations include:

• Severe headache
• Generalized seizures
• Visual disturbance
• Cortical blindness
• Altered mental status
• Confusion
• Reduced consciousness
• Nausea
• Vomiting
• Focal neurological deficits

Because these symptoms overlap substantially with acute ischemic stroke, rapid neuroimaging is indispensable.

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Diagnostic Workflow

Clinical Imaging Evaluation

Accurate imaging interpretation is the cornerstone of diagnosing Posterior Reversible Encephalopathy Syndrome (PRES). While clinical manifestations provide valuable clues, definitive diagnosis depends on recognizing characteristic imaging patterns and differentiating PRES from other neurological emergencies.

Modern neuroimaging follows a stepwise approach:

Emergency CT → Brain MRI → Advanced MRI Sequences → AI-assisted Interpretation → Clinical Decision Support

This multimodal strategy minimizes diagnostic delay and significantly improves patient outcomes.

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Computed Tomography (CT) Findings

The First Imaging Examination in the Emergency Department

Computed tomography remains the first-line imaging modality because it is:

• Rapid
• Widely available
• Excellent for detecting hemorrhage
• Essential for excluding acute neurosurgical emergencies

However, CT is relatively insensitive during the early stages of PRES.

Approximately one-third of patients demonstrate subtle or even normal CT findings despite significant neurological symptoms.

Radiologists should therefore avoid excluding PRES solely because the initial CT appears unremarkable.

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Typical CT Features

Characteristic CT abnormalities include:

• Bilateral low-attenuation lesions
• Symmetric white matter edema
• Parieto-occipital predominance
• Mild cortical involvement
• Preservation of gray-white differentiation
• Minimal mass effect
• Absence of vascular territorial infarction

Unlike ischemic stroke, lesions do not conform to a specific arterial distribution.

This imaging pattern reflects vasogenic edema, rather than infarction.

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Figure 1. Non-Contrast Brain CT

Radiologist Interpretation

Bilateral hypodense areas are identified within the posterior parietal and occipital white matter. No intracranial hemorrhage, midline shift, or acute territorial infarction is demonstrated.

The symmetric distribution strongly favors vasogenic edema consistent with Posterior Reversible Encephalopathy Syndrome (PRES).

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Magnetic Resonance Imaging (MRI)

Why MRI Is the Gold Standard

Magnetic Resonance Imaging provides substantially greater sensitivity than CT.

MRI not only detects PRES earlier but also characterizes:

• Lesion distribution
• Severity
• Complications
• Reversibility
• Differential diagnosis

For this reason, MRI has become the imaging modality of choice for suspected PRES.

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T2-Weighted Imaging

Typical findings include:

• Hyperintense white matter lesions
• Bilateral distribution
• Posterior cerebral predominance
• Minimal mass effect

Although the parieto-occipital lobes are most frequently affected, lesions may also involve:

• Frontal lobes
• Cerebellum
• Basal ganglia
• Brainstem
• Corpus callosum

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FLAIR Imaging

Fluid-Attenuated Inversion Recovery (FLAIR) sequences provide the highest sensitivity for vasogenic edema.

Typical MRI findings include:

• Symmetric cortical-subcortical hyperintensity
• Posterior white matter edema
• Cortical involvement
• Sulcal effacement
• Absence of significant enhancement

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Figure 2. Axial FLAIR MRI

Radiologist Interpretation

Extensive bilateral FLAIR hyperintensity is demonstrated within the parieto-occipital white matter.

The lesions exhibit classic imaging characteristics of vasogenic edema without evidence of space-occupying mass effect.

These findings are highly characteristic of Posterior Reversible Encephalopathy Syndrome.

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Diffusion-Weighted Imaging (DWI)

DWI represents one of the most important MRI sequences when differentiating PRES from acute cerebral infarction.

Typical PRES

• No restricted diffusion
• Vasogenic edema
• Increased extracellular water

Acute Ischemic Stroke

• Restricted diffusion
• Cytotoxic edema
• Irreversible neuronal injury

Therefore, DWI frequently provides the decisive imaging evidence for diagnosis.

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Apparent Diffusion Coefficient (ADC)

ADC mapping complements DWI.

Characteristic findings include:

• Increased ADC values
• Free diffusion
• Extracellular fluid accumulation

These findings support reversible vasogenic edema.

When ADC values become reduced, irreversible ischemic injury should be suspected.

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Figure 3. DWI and ADC Map

Radiologist Interpretation

No diffusion restriction is observed.

ADC maps demonstrate increased diffusivity corresponding to bilateral vasogenic edema.

These findings strongly support PRES rather than acute ischemic infarction.

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Advanced MRI Techniques

Modern neuroradiology increasingly incorporates advanced MRI sequences.

These include:

Susceptibility-Weighted Imaging (SWI)

Useful for detecting:

• Microhemorrhage
• Petechial hemorrhage
• Hemosiderin deposition

Approximately 15–30% of PRES patients demonstrate hemorrhagic complications.

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MR Perfusion

May demonstrate:

• Reduced cerebral blood flow
• Altered cerebral autoregulation
• Regional perfusion abnormalities

Perfusion imaging is particularly valuable in difficult diagnostic cases.

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MR Angiography (MRA)

Usually demonstrates:

• Normal intracranial arteries

Occasionally:

• Vasoconstriction
• Reversible cerebral vasospasm

This is particularly relevant in patients with concurrent Reversible Cerebral Vasoconstriction Syndrome (RCVS).

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Differential Diagnosis

Because PRES shares imaging findings with multiple neurological emergencies, careful differentiation is essential.

Disease	MRI Appearance	DWI	Key Clinical Clues
PRES	Bilateral posterior vasogenic edema	Usually negative	Hypertension, eclampsia, immunosuppressants
Acute Ischemic Stroke	Arterial territory infarction	Restricted diffusion	Sudden focal deficits
RCVS	May coexist with PRES	Usually normal	Thunderclap headache
Herpes Encephalitis	Temporal lobe involvement	Variable	Fever, altered consciousness
Acute Disseminated Encephalomyelitis (ADEM)	Multifocal white matter lesions	Variable	Recent infection or vaccination
Progressive Multifocal Leukoencephalopathy (PML)	Asymmetric white matter lesions	Usually negative	Severe immunosuppression

Recognition of these imaging distinctions prevents inappropriate treatments such as unnecessary thrombolysis.

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Artificial Intelligence in PRES Diagnosis

Artificial Intelligence is rapidly becoming an essential component of emergency neuroimaging.

Current AI applications include:

• Automated edema detection
• MRI lesion segmentation
• Brain abnormality classification
• Image prioritization
• Clinical triage
• Report generation assistance

Rather than replacing radiologists, AI functions as an intelligent decision-support system that enhances efficiency and diagnostic confidence.

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Deep Learning for Brain MRI

Convolutional Neural Networks (CNNs) have demonstrated remarkable performance in recognizing abnormal MRI patterns.

Potential applications include:

• Automatic FLAIR lesion detection
• White matter edema segmentation
• PRES probability scoring
• Follow-up comparison
• Disease progression monitoring

Future systems will likely integrate multimodal imaging with clinical data to provide more comprehensive diagnostic support.

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Clinical Decision Support System (CDSS)

A future AI-assisted workflow may proceed as follows:

Such workflows have the potential to reduce interpretation delays, improve triage in busy emergency departments, and support timely management of patients with PRES.

Key Imaging Pearls Every Radiologist Must Know

Posterior Reversible Encephalopathy Syndrome (PRES) remains one of the most important neurological emergencies because it is potentially reversible when diagnosed promptly. The following imaging pearls summarize the essential radiological features every neuroradiologist, emergency radiologist, and physician should recognize.

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1. MRI Is Significantly More Sensitive Than CT

Although non-contrast CT is the initial imaging examination in most emergency departments, early CT findings may be subtle or completely normal.

MRI—particularly FLAIR, DWI, and ADC sequences—is considerably more sensitive for detecting vasogenic edema.

Whenever PRES is clinically suspected despite a negative CT examination, MRI should be performed without delay.

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2. Symmetric Posterior Distribution Is the Hallmark

The classic imaging pattern consists of bilateral vasogenic edema involving:

• Parietal lobes
• Occipital lobes
• Posterior frontal lobes

The lesions typically demonstrate a remarkably symmetric distribution.

Although "posterior" involvement is characteristic, atypical presentations involving the cerebellum, basal ganglia, corpus callosum, or brainstem are increasingly recognized.

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3. Vasogenic Edema Is the Defining Imaging Feature

The pathological hallmark of PRES is vasogenic edema, produced by disruption of the blood-brain barrier.

Unlike ischemic stroke:

• extracellular water increases
• diffusion remains relatively unrestricted
• Neuronal injury is potentially reversible

Recognition of vasogenic edema fundamentally changes patient management.

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4. DWI and ADC Prevent Misdiagnosis

Diffusion-weighted imaging should always be interpreted together with ADC maps.

Typical PRES demonstrates:

• no diffusion restriction
• increased ADC values

Restricted diffusion suggests:

• acute cerebral infarction
• irreversible tissue injury
• poor prognosis

This distinction is among the most important diagnostic decisions in emergency neuroradiology.

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5. PRES Does Not Respect Vascular Territories

Unlike acute ischemic stroke, PRES lesions do not correspond to a single arterial distribution.

Instead, edema typically crosses vascular boundaries, producing bilateral cortical-subcortical abnormalities.

Recognition of this imaging pattern immediately narrows the differential diagnosis.

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6. Hemorrhage Is More Common Than Previously Believed

Advanced susceptibility-weighted imaging (SWI) has demonstrated that intracranial hemorrhage occurs in approximately 15–30% of patients.

Possible findings include:

• petechial hemorrhage
• focal hematoma
• subarachnoid hemorrhage

Failure to identify these complications may significantly alter treatment decisions.

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7. Imaging Must Always Be Interpreted Within Clinical Context

Radiologists should always consider:

• severe hypertension
• preeclampsia
• eclampsia
• renal failure
• autoimmune disease
• chemotherapy
• immunosuppressive therapy
• sepsis

Combining imaging findings with clinical history substantially improves diagnostic accuracy.

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8. Follow-Up MRI Confirms Reversibility

One defining characteristic of PRES is radiological improvement following treatment.

Serial MRI examinations frequently demonstrate:

• reduction of vasogenic edema
• normalization of FLAIR abnormalities
• restoration of normal brain architecture

Follow-up imaging therefore provides valuable confirmation of the diagnosis.

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9. AI Should Support—Not Replace—the Radiologist

Artificial intelligence excels at:

• lesion detection
• segmentation
• workflow prioritization
• quantitative analysis

However, the interpretation of complex neurological disorders still requires experienced neuroradiologists.

The future of neuroimaging lies in human–AI collaboration, not autonomous diagnosis.

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10. Early Diagnosis Determines Prognosis

Delayed recognition may result in:

• cerebral infarction
• intracranial hemorrhage
• permanent neurological disability
• death

Early diagnosis followed by aggressive treatment often leads to complete neurological recovery.

This emphasizes the central role of imaging in modern emergency medicine.

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Artificial Intelligence and the Future of PRES Diagnosis

From Image Interpretation to Intelligent Clinical Decision Support

Medical imaging is entering an era in which artificial intelligence extends far beyond simple image classification.

Future AI platforms will integrate:

• CT images
• MRI examinations
• Laboratory findings
• Electronic Health Records (EHR)
• Blood pressure trends
• Medication history
• Genomic information

to generate comprehensive diagnostic recommendations.

Rather than functioning as isolated algorithms, these systems will become intelligent clinical assistants.

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Foundation Models in Medical Imaging

Large multimodal foundation models are expected to transform radiology by simultaneously analyzing:

• imaging data
• radiology reports
• laboratory values
• physician notes
• pathology findings

Such systems may recognize subtle imaging patterns that are difficult to detect visually while generating structured differential diagnoses supported by current medical evidence.

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Explainable Artificial Intelligence (XAI)

One major challenge in healthcare AI is physician trust.

Explainable AI addresses this issue by displaying:

• heat maps
• lesion localization
• probability scores
• diagnostic reasoning
• confidence estimates

Instead of simply predicting "PRES detected," future systems will explain why the diagnosis is likely.

This transparency will improve physician acceptance and facilitate regulatory approval.

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Enterprise AI Platforms

Modern hospitals increasingly require integrated AI ecosystems rather than isolated software applications.

An enterprise medical imaging platform should seamlessly connect:

• PACS
• RIS
• Electronic Health Records
• Cloud Healthcare Infrastructure
• Clinical Decision Support Systems
• AI Diagnostic Software

Such integration enables continuous learning while minimizing workflow disruption.

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Digital Twin Technology

One of the most exciting future developments is the emergence of Digital Twin Medicine.

A patient's digital twin may continuously integrate:

• blood pressure
• imaging biomarkers
• laboratory values
• medication response
• physiological monitoring

allowing clinicians to simulate disease progression and personalize treatment strategies before irreversible brain injury occurs.

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Clinical Impact

Implementation of AI-supported emergency neuroimaging may provide measurable benefits.

Potential improvements include:

• Faster diagnosis
• Reduced reporting time
• Earlier blood pressure control
• Lower ICU admission rates
• Improved neurological outcomes
• Reduced healthcare costs
• Standardized imaging interpretation
• Enhanced patient safety

These benefits are particularly valuable in hospitals experiencing increasing imaging volumes and shortages of experienced neuroradiologists.

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Conclusion

Posterior Reversible Encephalopathy Syndrome represents one of the most important reversible neurological emergencies encountered in contemporary clinical practice.

Its diagnosis depends primarily upon recognition of characteristic neuroimaging findings.

Although CT remains the first imaging examination in most emergency departments, MRI—particularly FLAIR, DWI, and ADC sequences—provides the highest diagnostic accuracy.

The integration of artificial intelligence into emergency neuroradiology promises to transform clinical workflow through automated lesion detection, quantitative image analysis, intelligent triage, and real-time clinical decision support.

However, the future of radiology will not be defined by artificial intelligence alone.

Instead, it will be defined by collaboration between experienced physicians and trustworthy AI systems, combining computational power with clinical judgment to improve patient outcomes.

As healthcare enters the era of foundation models, cloud-native imaging platforms, and precision medicine, PRES serves as an excellent example of how advanced imaging and intelligent clinical decision support can together transform neurological emergency care.

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Clinical Take-Home Messages

✔ MRI remains the gold standard for diagnosing PRES.

✔ FLAIR and DWI sequences are essential for distinguishing vasogenic edema from acute infarction.

✔ AI can substantially improve emergency imaging workflow.

✔ Explainable AI is likely to become the future standard for clinical implementation.

✔ Human expertise remains indispensable for final diagnosis.

✔ Early diagnosis dramatically improves prognosis.

 

Frequently Asked Questions

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1. What is Posterior Reversible Encephalopathy Syndrome (PRES)?

Posterior Reversible Encephalopathy Syndrome (PRES) is a clinicoradiological syndrome characterized by acute neurological symptoms accompanied by reversible vasogenic cerebral edema. Patients commonly present with seizures, headache, visual disturbances, confusion, altered mental status, and severe hypertension. MRI is considered the gold standard for diagnosis because it is highly sensitive for detecting vasogenic edema within the posterior cerebral hemispheres.

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2. Is PRES a Stroke?

No.

Although PRES frequently mimics acute ischemic stroke, the underlying pathophysiology differs significantly.

Stroke results from arterial occlusion and irreversible cytotoxic edema, whereas PRES results primarily from disruption of the blood-brain barrier leading to reversible vasogenic edema.

Diffusion-weighted imaging (DWI) and ADC mapping are particularly useful for distinguishing these two conditions.

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3. Which Imaging Modality Is Best for Diagnosing PRES?

Magnetic Resonance Imaging (MRI) is the preferred imaging modality.

The most valuable MRI sequences include:

• FLAIR
• Diffusion-Weighted Imaging (DWI)
• ADC Mapping
• T2-weighted Imaging
• Susceptibility-Weighted Imaging (SWI)

Although CT is often performed initially, MRI demonstrates substantially greater sensitivity.

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4. What Causes PRES?

Several clinical conditions may trigger PRES.

The most common include:

• Severe hypertension
• Hypertensive emergency
• Preeclampsia
• Eclampsia
• Organ transplantation
• Chemotherapy
• Immunosuppressive therapy
• Autoimmune diseases
• Sepsis
• Acute kidney injury

The underlying mechanism involves endothelial dysfunction and failure of cerebral autoregulation.

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5. Is PRES Completely Reversible?

Most patients experience substantial neurological recovery when diagnosis and treatment occur promptly.

However, delayed diagnosis may lead to:

• Cerebral infarction
• Intracranial hemorrhage
• Permanent neurological deficits
• Death

Early recognition remains the single most important prognostic factor.

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6. Can Artificial Intelligence Diagnose PRES?

Artificial Intelligence cannot independently establish a clinical diagnosis.

However, modern AI systems can assist radiologists by:

• Detecting abnormal MRI findings
• Segmenting vasogenic edema
• Prioritizing emergency cases
• Generating preliminary reports
• Supporting Clinical Decision Support Systems

The final diagnosis should always be confirmed by qualified physicians.

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7. How Does AI Improve Emergency Neuroimaging?

AI offers several advantages:

• Faster image triage
• Automated lesion detection
• Quantitative edema analysis
• Workflow optimization
• Reduced reporting delays
• Improved diagnostic consistency

These improvements may shorten the time to treatment in emergency departments.

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8. What Are the Typical MRI Findings of PRES?

Classic MRI findings include:

• Bilateral parieto-occipital FLAIR hyperintensity
• Vasogenic edema
• No diffusion restriction
• Increased ADC values
• Symmetric cortical-subcortical involvement

These imaging characteristics strongly support the diagnosis.

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9. Can PRES Occur Without Hypertension?

Yes.

Although hypertension is the most common precipitating factor, PRES may also occur in normotensive patients receiving:

• Tacrolimus
• Cyclosporine
• Chemotherapy
• Immunotherapy

or in patients with autoimmune diseases and sepsis.

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10. Why Is PRES Important for Radiologists?

Recognition of PRES directly influences patient management.

Prompt diagnosis allows:

• Blood pressure control
• Medication adjustment
• Intensive monitoring
• Prevention of permanent neurological injury

Radiologists, therefore, play a central role in improving patient outcomes.

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Clinical Practice Guidelines

When Should PRES Be Suspected?

Radiologists should immediately consider PRES when imaging demonstrates:

✓ Bilateral posterior white matter edema

✓ Symmetric FLAIR hyperintensity

✓ Vasogenic edema without restricted diffusion

✓ Clinical history of hypertension, eclampsia, transplantation, or chemotherapy

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MRI Protocol Recommendation

Recommended MRI protocol:

• Axial T1
• Axial T2
• FLAIR
• DWI
• ADC
• SWI
• Post-contrast T1 (when indicated)
• MR Angiography (selected cases)

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Future Trends in Medical Imaging AI

Medical imaging is entering an unprecedented period of innovation.

Over the next decade, radiology will likely evolve through:

Foundation AI Models

Large multimodal AI models capable of integrating:

• CT
• MRI
• PET
• Ultrasound
• Clinical notes
• Laboratory findings

into a unified diagnostic framework.

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Autonomous Workflow Assistance

Future AI systems will automatically:

• Detect abnormalities
• Prioritize urgent examinations
• Draft radiology reports
• Recommend differential diagnoses
• Suggest follow-up imaging

while leaving the final interpretation to physicians.

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Explainable AI

Regulatory agencies increasingly require AI systems to explain their reasoning.

Future algorithms will provide:

• Heat maps
• Probability estimates
• Lesion localization
• Confidence intervals
• Diagnostic explanations

This transparency will increase physician confidence and facilitate clinical adoption.

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Precision Medicine

Medical imaging will become increasingly integrated with:

• Genomics
• Proteomics
• Biomarkers
• Wearable devices
• Electronic Health Records

Allowing individualized diagnosis and treatment planning.

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Final Thoughts

Posterior Reversible Encephalopathy Syndrome is a remarkable example of how advanced neuroimaging can transform patient care.

The combination of MRI, neuroradiology expertise, and artificial intelligence enables earlier diagnosis, more accurate differentiation from stroke, and more timely treatment.

As AI continues to mature, radiologists will increasingly transition from image interpreters to information managers, integrating imaging findings with clinical data to provide personalized, evidence-based care.

The future of emergency neuroradiology is not defined by machines replacing physicians. Rather, it is defined by intelligent collaboration between human expertise and trustworthy AI, delivering faster diagnoses, safer decisions, and better outcomes for patients worldwide.

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References

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2. Bartynski WS. Posterior Reversible Encephalopathy Syndrome, Part 1: Fundamental Imaging and Clinical Features. American Journal of Neuroradiology. 2008;29:1036–1042. DOI: 10.3174/ajnr.A0928
3. Bartynski WS. Posterior Reversible Encephalopathy Syndrome, Part 2: Controversies Surrounding Pathophysiology. American Journal of Neuroradiology. 2008;29:1043–1049. DOI: 10.3174/ajnr.A0929
4. Hinduja A. Posterior Reversible Encephalopathy Syndrome: Clinical Features and Outcome. Frontiers in Neurology. 2020. DOI: 10.3389/fneur.2020.00071
5. McKinney AM, et al. Posterior Reversible Encephalopathy Syndrome: Incidence of Atypical Regions of Involvement and Imaging Findings. AJR American Journal of Roentgenology.