{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:18:11Z","timestamp":1791566291205,"version":"4.3.4"},"reference-count":43,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T00:00:00Z","timestamp":1755475200000},"content-version":"vor","delay-in-days":48,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neuroimaging"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Purpose<\/jats:title>\n                    <jats:p>Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state with characteristic imaging findings. While classic PRES typically involves parieto\u2010occipital edema, atypical cases present with variable involvement of deep gray nuclei, brainstem, cerebellum, and corpus callosum, which may complicate diagnosis. This study aims to characterize the neuroimaging features of \u201catypical\u201d PRES in a large cohort and evaluate relationships with clinical variables and outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively analyzed neuroimaging data from patients diagnosed with PRES, identifying cases with atypical edema patterns. Relationships between MRI findings, clinical variables, and outcomes were assessed with univariable and multivariable regression analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 184 PRES cases were analyzed. 71.7% had \u201catypical\u201d imaging findings. Atypical edema was associated with older age (odds ratio [OR] 2.96 \u226552 years,\n                      <jats:italic>p<\/jats:italic>\n                      = 0.002) and negatively associated with pregnancy (OR 0.20,\n                      <jats:italic>p<\/jats:italic>\n                      &lt;0.001). These associations were seen in a subset of atypical locations, particularly those supplied by the posterior circulation. Additionally, certain atypical edema patterns were correlated with prolonged hospital stays and reduced clinical reversibility, suggesting a potential impact on patient outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this large series of PRES cases, atypical imaging findings were common. Atypical edema, including a posterior circulation pattern, was seen more commonly in older patients, less commonly in pregnancy, and may represent a more severe form of this syndrome with worse outcomes. Recognizing these atypical imaging patterns is crucial for timely intervention and improved patient outcomes.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/jon.70078","type":"journal-article","created":{"date-parts":[[2025,8,18]],"date-time":"2025-08-18T07:12:45Z","timestamp":1755501165000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Atypical Edema in Posterior Reversible Encephalopathy Syndrome: Clinical Associations and Outcome"],"prefix":"10.1111","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5241-799X","authenticated-orcid":false,"given":"Andrew C.","family":"McClelland","sequence":"first","affiliation":[{"name":"Division of Neuroradiology Department of Radiology, NYU Langone Medical Center  New York New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin A.","family":"Ellis","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emory","family":"Kuo","sequence":"additional","affiliation":[{"name":"Riverhills Neuroscience  Cincinnati Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenny Q.","family":"Ye","sequence":"additional","affiliation":[{"name":"Department of Epidemiology &amp; Population Health (Biostatistics), Department of Systems &amp; Computational Biology Albert Einstein College of Medicine  Bronx New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ramani","family":"Balu","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4025-115X","authenticated-orcid":false,"given":"Suyash","family":"Mohan","sequence":"additional","affiliation":[{"name":"Division of Neuroradiology Department of Radiology, Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2025,8,18]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0928"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2020.00071"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2114482"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ncl.2024.07.008"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0044534"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jns.2014.09.019"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.3174\/ajnr.A0549"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1291\/hypres.25.797"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.07.2024"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-011-6152-4"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2011.05.010"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.2214\/AJR.12.9677"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/WCO.0000000000000640"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-016-8377-8"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jstrokecerebrovasdis.2016.03.042"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/jemt.1075"},{"key":"e_1_2_7_18_1","first-page":"1199","article-title":"Posterior Reversible Encephalopathy Syndrome: Utility of Fluid\u2010Attenuated Inversion Recovery MR Imaging in the Detection of Cortical and Subcortical Lesions","volume":"21","author":"Casey S. 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