17 year old girl presented with acute onset history of headache, blurring of vision and seizures. She was a known case of chronic kidney disease, and was awaiting a kidney transplant. Her BP at persentation was 200/140 mmHg.
CT brain done showed bilateral parieto-occipital hypodensities. A diagnosis of posterior reversible encephalopathy syndrome (PRES) was made.
She was started on antiepileptic and antihypertensive medications. She showed rapid improvement and was asymptomatic within 48 hours of initiating the treatment. Lowering the blood pressure (to a target BP of 120-140 mmHg systolic) is the single most important factor that predicts a better outcome in patients suffering from PRES.