PMC8772586_01
Computed tomography image of brain. There was a small amount of hemorrhage in the left temporal lobe (arrow).
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F1
Her head CT scan showed a small amount of hemorrhage in the left temporal lobe (Figure 1).
Magnetic resonance imaging (MRI) of brain. T2-weighted (A-1) and FLAIR (A-2) sequences depict hyper-intense lesions involving the bilateral cerebral hemispheres (occipital lobe, parietal lobe, temporal lobe and frontal lobe) and cerebral cortex and subcortex (arrows), most of which disappeared 17 days later (B-1,B-2). Diffusion-weighted magnetic resonance imaging (A-3) and apparent diffusion coefficient (A-4) sequences of the involved regions showed isointense or hyperintensity lesions (arrows).
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F2
Brain magnetic resonance image (MRI) revealed multiple foci lesions under bilateral cortex of the superior frontal sulcus, parieto-occipital and watershed area was dominant, which suggested typical PRES features (Figures 2A1-4). The follow-up brain MRI after 17 days showed that the degree of gyrus swelling was reduced, most of the abnormal high signal shadows disappeared and multiple small ischemic lesions were found under bilateral frontal-parietal cortex (Figures 2B1,2).
Clinical findings timeline. MPA, microscopic polyangiitis; GC, glucocorticoid; CTX, cyclophosphamide; PE, plasmapheresis; RTX, rituximab; RF, renal function; PRES, posterior reversible encephalopathy syndrome; HD, hemodialysis.
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F3
Brain magnetic resonance image (MRI) revealed multiple foci lesions under bilateral cortex of the superior frontal sulcus, parieto-occipital and watershed area was dominant, which suggested typical PRES features (Figures 2A1-4). The clinical findings timeline was presented in Figure 3.