Kühn AL, Huch B, Wendt G, Dooms G, Droste DW. First description of posterior reversible encephalopathy syndrome as a complication of glycerolnitrate patch following open cardiac surgery.
Acta Neurol Scand: 2011: 124: 218–220.
© 2010 John Wiley & Sons A/S.
Background– Posterior reversible encephalopathy syndrome (PRES) affects predominantly the parietal and occipital lobes. Frequent clinical features are epileptic seizure, altered mental status and visual disturbances.
Clinical Presentation – We present the first case of a patient with pericarditis and mitral valve insufficiency, who developed PRES after application of a glycerolnitrate patch day three post‐operatively and whose neurological deficits improved within 2 days after withdrawal of patch therapy.
Conclusion – The precise pathomechanism of PRES is unknown. The lower sympathetic innervation of the posterior circulation may be one explanation for its particular vulnerability to vasodilatation caused by glycerolnitrate.