Ayşe ÖZCAN, Namık ÖZCAN, Hülya BAŞAR, Aziz KAYA, Züleyha ERCAN, Halil ERTAŞ, Çetin KAYMAK

YOĞUN BAKIMDA TANI ALAN "POSTERIOR REVERSIBLE ENSEFALOPATİ-PRES- SENDROMU"

Posterior Reversible Ensefalopati Sendromu (PRES), klinikte sık olarak baş ağrısı, bulantı, kusma, görsel bozukluklar, letarji, stupor gibi semptomlarla kendini gösteren, tanısı ise klinik, radyolojik ve nörolojik olarak konulan geçici bir tablodur. Etyolojide hipertansif ensefalopati, preeklampsi, eklampsi, son dönem karaciğer ve böbrek yetmezliği, maligniteler, immun yetmezlik oluşturan hastalıklar ve nadir olarak da, bazı ilaçların kullanımı sonrasında gelişen hipertansif ataklar bulunmaktadır. Hastaların çoğunun hipertansif olduğu bilinmektedir.Otuz iki yaşında bilinen kronik böbrek hastalığı olan ve kronik dializ tedavisi gören bayan hasta, ani şuur kaybı gelişmesi üzerine, yoğun bakıma kabul edilerek, yapılan takip ve radyolojik incelemeler sonucu PRES tanısı almıştır. Literatürdeki olgulara göre iyileşme süreci belirgin uzun olan hasta 49. gün salah ile taburcu edilmiştir. PRES tablosu, yoğun bakım hekimleri tarafından akılda bulundurulması gereken, erken tanı ve tedavi ile geri dönüşümü yüz güldürücü bir nörolojik sendromdur.

A "POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES)" IN INTENSIVE CARE UNIT

Posterior Reversible Encephalopathy Syndrome (PRES) is a transient situation which is clinically presented with headache, nausea, vomiting, visual disturbances, lethargy and stupor and diagnosed by neurological examination and radiologic findings. The etiology of PRES includes hypertensive encephalopathy, preeclampsia, eclampsia, end-stage liver or renal failure, malignancies, immune deficiency and rarely hypertensive attacks following administration of some drugs. Most of the patients are known to be hypertensive. 32 years old female patient with previous diagnosis of chronic renal failure was admitted to intensive care unit with sudden loss of concious after dialysis. She was diagnosed as PRES after clinical and radiologic evaluation. Evaluation of the cases reported in the literature showed that the recovery lasts quite long. The patient was discharged on the 49th day. PRES is a neurologic syndrome which has favourable results following early diagnosis and treatment and should be in mind for all intensivists.

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