TABLE 1

Summary of the clinical, retinal, and MRI findings in 11 Indian patients with nonfatal CM and with PRES or PRES-like features

Patient group, IDaAgeSexbKey clinical features (no. of seizures; drug history; BP [mm Hg]; creatinine [mg/dl])cHighest temp (°F)MRI 1 (10 h)Clinical features (10 h)eFeatures of MRI 2 (48–72 h)Associated clinical features (48–72 h)Features of MRI 3 (1 mo)Associated clinical features (1 mo)Classification
FeaturesType of edemadGCSRetCompParasitemia (parasites/µl)GCSRetCompParasitemia (parasites/µl)GCSRetCompParasitemia (parasites/µl)
Adults
    640 F2; NA; 120/80; 1.099Marked generalized thickness of cortex in right parieto-occipital region; features of vascular engorgementVasogenic edema with some features of ischemia consistent with vascular engorgement6/15No291Nearly complete resolutions of cortical changes15/15NPNoClearNP15/15NPNoClearPRES-like
    1732M2; 0; BP, 120/80; 1.698.6Marked generalized thickening of entire cortical mantle; bilateral effacement of sulci in posterior, temporal, parietal, and occipital lobesVasogenic edemaf5/15+ (H [1–5])Yes (J)58,178Nearly complete resolutions of cortical changes14/15+ (H [6–20])Yes (J)ClearNP15/15NoClearPRES
    2223M0; AM + AP; 110/70; 16.599.2Marked generalized thickness of cortical mantle, right hemisphere involvement greater than left; localized effacement of sulciVasogenic edemaf9/15Yes (J + AKI)12,372Nearly complete resolutions of cortical changes15/15NPYes (AKI)ClearNormal findings15/15NPNoClearPRES
    2822M2; NA; 110/70; 1.1100.9Mild generalized thickening of entire cortical mantle; bilateral focal effacement of sulci in parietal and occipital lobesVasogenic edema with some features of ischemia consistent with vascular engorgement affecting BG5/15+ (H [1–5])Yes (J)12,654Complete resolutions of cortical changes14/15+ (H [1–5])NoClearNormal findings15/15NoClearPRES-like
    6029M0; AM; 110/90; 3.2100Moderate generalized thickening of entire cortical mantle; right hemisphere involvement greater than left and posterior greater than anterior on each side; generalized sulcal effacementVasogenic edema with some features of ischemia consistent with vascular engorgement affecting BG, thalami, and subcortical WM6/15Yes (J + AKI)378Complete resolutions of cortical changes15/15NPYes (J)ClearNP15/15NPNoClearPRES-like
Children
    3112M0; AP; 110/80; 0.598.6Moderate generalized thickening of entire cortical mantle with sulcal effacement of temporal, parietal, and occipital lobesVasogenic edema7/15No21,931Partial resolutions of cortical changes15/15+ (H [1–5])NoClearNPC15/15NoClearPRES
    3215M0; AP; 90/60; 0.5100Mild generalized thickening of cortical mantle, posterior greater than anteriorVasogenic edema9/15No203Partial resolutions of cortical changes15/15+ (H [1–5])NoClearNPC15/15NoClearPRES
    335M0; AP; 90/70; 1.398.8Moderate generalized thickening of entire cortical mantle with generalized sulcal effacement, more pronounced in posterior temporal parietal, and occipital lobesVasogenic edemaf7/15Yes (J)12,887No significant improvement15/15Yes (J + AKI)fClearNPC15/15NPNoClearPRES
    4111M0; AM; 130/110; 0.799Marked generalized cortical thickening of entire cortical mantle, global widespread sulcal effacementVasogenic edema with some features of ischemia consistent with vascular engorgement affecting subcortical WM5/15Yes (J)14,750Nearly complete resolutions of cortical changes15/15Data NAClearNormal findings15/15NPNoClearPRES-like
    4612F0; AM; 87/60; 0.5100Marked generalized cortical thickening of entire cortical mantle, widespread sulcal effacement in posterior temporal parietal, and occipital lobesVasogenic edema with some features of ischemia consistent with vascular engorgement affecting subcortical WM and BG (LN)6/15+ (H [1–5])Yes (SA)163Nearly complete resolutions of cortical changes15/15Data NAClearNP15/15NPNoClearPRES-like
    595M2; NA; 90/60; 0.7100.4Moderate cortical thickening of right frontal, temporal, and parietal lobes, mild cortical thickening of left posterior parietal, and occipital lobesVasogenic edema6/15No219,097Nearly complete resolutions of cortical changes14/15No200NP15/15NPNoClearPRES-like
  • a ID, identification number.

  • b F, female; M, male.

  • c Drug history, treatment prior to admission; NA, not available; AM, antimalarial drug; AP, antipyretic drug; BP, blood pressure on admission (systolic/diastolic); creatinine, laboratory range is 0.8 to 1.4 mg/dl.

  • d BG, basal ganglia; WM, white matter; LN, lentiform nucleus.

  • e GCS, Glasgow coma score; Ret, retinopathies; +, present; −, absent; H, hemorrhages (number of retinal hemorrhages); Comp, complication; J, jaundice; AKI, acute kidney injury; SA, severe anemia; NP, not performed (not necessary); NPC, not performed (conscious and noncooperative pediatric patients).

  • f Perfusion, CBV, CBF, and MTT were not available.