Posterior Reversible Encephalopathic Syndrome in the Setting of Induced Elevated Mean Arterial Pressure in Patients with Spinal Cord Injury

Alexander C. Whiting, Manuel P. Fanarjian, Randall J. Hlubek, Jakub Godzik, U. Kumar Kakarla, Nicholas Theodore

Research output: Contribution to journalArticle

Abstract

BACKGROUND AND IMPORTANCE Acute spinal cord injury (SCI) is managed by avoiding hypotension and elevating mean arterial pressure (MAP) to attain optimal perfusion of the spinal cord. Few studies have been published regarding complications related to this treatment paradigm. CLINICAL PRESENTATION Three patients with SCI developed posterior reversible encephalopathic syndrome (PRES) during treatment with intravenous fluids and vasopressors administered to maintain elevated MAPs. All of them experienced temporary elevations well above the standard blood pressure goals for acute SCI and deterioration of neurological status. CONCLUSION PRES is a potential complication of elevated MAPs in patients with SCI, particularly if the blood pressure rises above the goals of standard treatment paradigms. The neurosurgical staff should be suspicious of possible PRES early in the course of acute SCI in patients with unexplained neurological decline. This case series is the first report of PRES in patients with acute SCI.

Original languageEnglish (US)
Pages (from-to)E16-E20
JournalClinical Neurosurgery
Volume83
Issue number1
DOIs
StatePublished - Jul 1 2018
Externally publishedYes

Fingerprint

Spinal Cord Injuries
Arterial Pressure
Blood Pressure
Hypotension
Spinal Cord
Therapeutics
Perfusion

Keywords

  • Mean arterial pressure
  • PRES
  • Spinal cord injury

ASJC Scopus subject areas

  • Surgery
  • Clinical Neurology

Cite this

Posterior Reversible Encephalopathic Syndrome in the Setting of Induced Elevated Mean Arterial Pressure in Patients with Spinal Cord Injury. / Whiting, Alexander C.; Fanarjian, Manuel P.; Hlubek, Randall J.; Godzik, Jakub; Kumar Kakarla, U.; Theodore, Nicholas.

In: Clinical Neurosurgery, Vol. 83, No. 1, 01.07.2018, p. E16-E20.

Research output: Contribution to journalArticle

Whiting, Alexander C. ; Fanarjian, Manuel P. ; Hlubek, Randall J. ; Godzik, Jakub ; Kumar Kakarla, U. ; Theodore, Nicholas. / Posterior Reversible Encephalopathic Syndrome in the Setting of Induced Elevated Mean Arterial Pressure in Patients with Spinal Cord Injury. In: Clinical Neurosurgery. 2018 ; Vol. 83, No. 1. pp. E16-E20.
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