1. Síndrome de encefalopatía posterior reversible en pacientes críticos COVID-19: reporte de 2 casos
- Author
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M.P. Tauler Redondo, M.B. Lozano Serrano, J. López-Torres López, M.L. Sánchez López, J.J. Tortajada-Soler, and M. Garví López
- Subjects
Pathology ,medicine.medical_specialty ,Endothelium ,business.industry ,Encephalopathy ,Posterior reversible encephalopathy syndrome ,Neurological disorder ,Critical Care and Intensive Care Medicine ,medicine.disease ,Sepsis ,Epilepsy ,Anesthesiology and Pain Medicine ,medicine.anatomical_structure ,Edema ,medicine ,Endothelial dysfunction ,medicine.symptom ,business - Abstract
Posterior reversible encephalopathy syndrome (PRES) is an acute neurological disorder characterized by variable symptoms and radiological images characteristic of vasogenic parietal-occipital edema. It is associated with clinical conditions such as high blood pressure, infection / sepsis, or cytotoxic / immunosuppressive drugs, among others. It is characterized pathophysiologically by endothelial damage with breakdown of blood-brain barrier (BBB), cerebral hypoperfusion, and vasogenic edema.The cases are presented on two critical COVID-19 patients who were admitted to pneumonia requiring mechanical ventilation and who, after removing sedation, developed acute and reversible neurological symptoms consisting of epilepsy and encephalopathy, associated with hyperintense subcortical lesions on brain magnetic resonance imaging (MRI) compatible with PRES.SARS-CoV-2 coronavirus would activate an inflammatory response that would damage brain endothelium. It could be triggered by cytokine release, as well as by direct viral injury, given that endothelium expresses ACE2 receptors. It could explain the possible association between PRES and COVID-19.
- Published
- 2023