{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T23:33:16Z","timestamp":1769729596235,"version":"3.49.0"},"reference-count":34,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"18","license":[{"start":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T00:00:00Z","timestamp":1730073600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Cosmet Laser Ther"],"published-print":{"date-parts":[[2024,10,28]]},"abstract":"\n BACKGROUND<\/jats:title>\n An 80-year-old male was found to have a metastatic lesion in his cerebrum. He underwent uncomplicated resection with prolonged inhalational anesthesia due to issues with intravenous access prior to surgery. Postoperatively, the patient had persistent altered mental status. Immediate postoperative head computed tomography and continuous electroencephalography were negative for possible causes.<\/jats:p>\n <\/jats:sec>\n \n OBSERVATIONS<\/jats:title>\n Standard brain magnetic resonance imaging (MRI) after metastatic resection demonstrated the development of edema in his pons and thalami, concerning for posterior reversible encephalopathy syndrome (PRES). Tight blood pressure control was initiated. His neurological examination returned to baseline. Follow-up MRI showed the resolution of edema.<\/jats:p>\n <\/jats:sec>\n \n LESSONS<\/jats:title>\n This is a report of PRES hypothesized to be attributable to prolonged inhalational anesthetic. PRES is a disorder in which patients present with altered mentation, seizures, visual impairment, or headache. PRES often occurs due to acute uncontrolled hypertension; however, other conditions, including autoimmune disease and cancer chemotherapy, have been linked. In severe cases, permanent brain damage and death have been reported. The authors present a case of PRES as the cause of severe neurological decline following craniotomy without severe or sustained hypertension. The authors hypothesize that PRES could be caused by blood pressure variability in the perioperative period and prolonged anesthesia.<\/jats:p>\n \n https:\/\/thejns.org\/doi\/10.3171\/CASE24245<\/jats:ext-link>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3171\/case24245","type":"journal-article","created":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T02:44:24Z","timestamp":1730083464000},"source":"Crossref","is-referenced-by-count":0,"title":["Atypical posterior reversible encephalopathy syndrome following craniotomy for a metastatic lesion: illustrative case"],"prefix":"10.3171","volume":"8","author":[{"given":"Michael","family":"Sun","sequence":"first","affiliation":[{"name":"Departments of Neurosurgery, University of Florida Shands Hospital, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kaitlyn F","family":"Melnick","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, University of Florida Shands Hospital, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raquel","family":"Buser","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology, University of Florida Shands Hospital, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thiago","family":"Carneiro","sequence":"additional","affiliation":[{"name":"Departments of Neurology, University of Florida Shands Hospital, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivan","family":"Rocha Ferreira Da Silva","sequence":"additional","affiliation":[{"name":"Departments of Neurology, University of Florida Shands Hospital, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maryam","family":"Rahman","sequence":"additional","affiliation":[{"name":"Departments of Neurosurgery, University of Florida Shands Hospital, Gainesville, Florida"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1754","reference":[{"issue":"5","key":"bib1","series-title":"Korean J Anesthesiol","first-page":"369","article-title":"Posterior reversible encephalopathy syndrome in an untreated hypertensive patient after spinal surgery under general anesthesia\u2014a case report","volume":"60","author":"Yi","year":"2011","unstructured":"Yi JHHa SHKim YKChoi EM. Posterior reversible encephalopathy syndrome in an untreated hypertensive patient after spinal surgery under general anesthesia\u2014a case report. Korean J Anesthesiol. 2011;60(5):369-372."},{"issue":"1","key":"bib2","series-title":"J Anesth","first-page":"111","article-title":"A case of posterior reversible encephalopathy syndrome after emergence from anesthesia","volume":"26","author":"Inoue","year":"2012","unstructured":"Inoue SKawaguchi MFuruya H. A case of posterior reversible encephalopathy syndrome after emergence from anesthesia. J Anesth. 2012;26(1):111-114."},{"issue":"8","key":"bib3","series-title":"N Engl J Med","first-page":"494","article-title":"A reversible posterior leukoencephalopathy syndrome","volume":"334","author":"Hinchey","year":"1996","unstructured":"Hinchey JChaves CAppignani B, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med. 1996;334(8):494-500."},{"issue":"7","key":"bib4","series-title":"Eur J Anaesthesiol","first-page":"543","article-title":"Effects of sevoflurane on cerebral blood flow and cerebral metabolic rate of oxygen in human beings: a comparison with isoflurane","volume":"20","author":"Oshima","year":"2003","unstructured":"Oshima TKarasawa FOkazaki YWada HSatoh T. Effects of sevoflurane on cerebral blood flow and cerebral metabolic rate of oxygen in human beings: a comparison with isoflurane. Eur J Anaesthesiol. 2003;20(7):543-547."},{"issue":"4","key":"bib5","series-title":"Anaesth Intensive Care","first-page":"598","article-title":"Differential increases in blood flow velocity in the middle cerebral artery after tourniquet deflation during sevoflurane, isoflurane or propofol anaesthesia","volume":"37","author":"Kadoi","year":"2009","unstructured":"Kadoi YKawauchi CHIde MSaito SMizutani A. Differential increases in blood flow velocity in the middle cerebral artery after tourniquet deflation during sevoflurane, isoflurane or propofol anaesthesia. Anaesth Intensive Care. 2009;37(4):598-603."},{"issue":"10","key":"bib6","series-title":"Crit Care Med","first-page":"2797","article-title":"Inhalation versus endovenous sedation in subarachnoid hemorrhage patients: effects on regional cerebral blood flow","volume":"40","author":"Villa","year":"2012","unstructured":"Villa FIacca CMolinari AF, et al. Inhalation versus endovenous sedation in subarachnoid hemorrhage patients: effects on regional cerebral blood flow. Crit Care Med. 2012;40(10):2797-2804."},{"issue":"5","key":"bib7","series-title":"Korean J Anesthesiol","first-page":"323","article-title":"Cerebral blood flow change during volatile induction in large-dose sevoflurane versus intravenous propofol induction: transcranial Doppler study","volume":"67","author":"Jung","year":"2014","unstructured":"Jung HSSung TYKang HKim JSKim TY. Cerebral blood flow change during volatile induction in large-dose sevoflurane versus intravenous propofol induction: transcranial Doppler study. Korean J Anesthesiol. 2014;67(5):323-328."},{"issue":"3","key":"bib8","series-title":"Acta Anaesthesiol Scand","first-page":"306","article-title":"Effects of dose-dependent levels of isoflurane on cerebral blood flow in healthy subjects studied using positron emission tomography","volume":"50","author":"Schl\u00fcnzen","year":"2006","unstructured":"Schl\u00fcnzen LCold GERasmussen MVafaee MS. Effects of dose-dependent levels of isoflurane on cerebral blood flow in healthy subjects studied using positron emission tomography. Acta Anaesthesiol Scand. 2006;50(3):306-312."},{"issue":"10","key":"bib9","series-title":"Acta Anaesthesiol Scand","first-page":"1268","article-title":"Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study","volume":"48","author":"Schl\u00fcnzen","year":"2004","unstructured":"Schl\u00fcnzen LVafaee MSCold GERasmussen MNielsen JFGjedde A. Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study. 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Effects of surgical levels of propofol and sevoflurane anesthesia on cerebral blood flow in healthy subjects studied with positron emission tomography. Anesthesiology. 2002;96(6):1358-1370."},{"issue":"10","key":"bib16","series-title":"Paediatr Anaesth","first-page":"946","article-title":"Impact of sevoflurane anesthesia on cerebral blood flow in children younger than 2 years","volume":"23","author":"Rhondali","year":"2013","unstructured":"Rhondali OMahr ASimonin-Lansiaux S, et al. Impact of sevoflurane anesthesia on cerebral blood flow in children younger than 2 years. Paediatr Anaesth. 2013;23(10):946-951."},{"issue":"2","key":"bib17","series-title":"Eur J Anaesthesiol","first-page":"179","article-title":"Effect of sevoflurane on cerebral blood flow and cerebrovascular resistance at surgical level of anaesthesia: a transcranial Doppler study","volume":"24","author":"Moln\u00e1r","year":"2007","unstructured":"Moln\u00e1r CSettakis GS\u00e1rk\u00e1ny PK\u00e1lm\u00e1n SSzab\u00f3 SF\u00fclesdi B. Effect of sevoflurane on cerebral blood flow and cerebrovascular resistance at surgical level of anaesthesia: a transcranial Doppler study. Eur J Anaesthesiol. 2007;24(2):179-184."},{"issue":"5","key":"bib1","series-title":"Korean J Anesthesiol","first-page":"369","article-title":"Posterior reversible encephalopathy syndrome in an untreated hypertensive patient after spinal surgery under general anesthesia\u2014a case report","volume":"60","author":"Yi","year":"2011","unstructured":"Yi JHHa SHKim YKChoi EM. Posterior reversible encephalopathy syndrome in an untreated hypertensive patient after spinal surgery under general anesthesia\u2014a case report. Korean J Anesthesiol. 2011;60(5):369-372."},{"issue":"1","key":"bib2","series-title":"J Anesth","first-page":"111","article-title":"A case of posterior reversible encephalopathy syndrome after emergence from anesthesia","volume":"26","author":"Inoue","year":"2012","unstructured":"Inoue SKawaguchi MFuruya H. A case of posterior reversible encephalopathy syndrome after emergence from anesthesia. J Anesth. 2012;26(1):111-114."},{"issue":"8","key":"bib3","series-title":"N Engl J Med","first-page":"494","article-title":"A reversible posterior leukoencephalopathy syndrome","volume":"334","author":"Hinchey","year":"1996","unstructured":"Hinchey JChaves CAppignani B, et al. A reversible posterior leukoencephalopathy syndrome. 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Differential increases in blood flow velocity in the middle cerebral artery after tourniquet deflation during sevoflurane, isoflurane or propofol anaesthesia. Anaesth Intensive Care. 2009;37(4):598-603."},{"issue":"10","key":"bib6","series-title":"Crit Care Med","first-page":"2797","article-title":"Inhalation versus endovenous sedation in subarachnoid hemorrhage patients: effects on regional cerebral blood flow","volume":"40","author":"Villa","year":"2012","unstructured":"Villa FIacca CMolinari AF, et al. Inhalation versus endovenous sedation in subarachnoid hemorrhage patients: effects on regional cerebral blood flow. Crit Care Med. 2012;40(10):2797-2804."},{"issue":"5","key":"bib7","series-title":"Korean J Anesthesiol","first-page":"323","article-title":"Cerebral blood flow change during volatile induction in large-dose sevoflurane versus intravenous propofol induction: transcranial Doppler study","volume":"67","author":"Jung","year":"2014","unstructured":"Jung HSSung TYKang HKim JSKim TY. Cerebral blood flow change during volatile induction in large-dose sevoflurane versus intravenous propofol induction: transcranial Doppler study. Korean J Anesthesiol. 2014;67(5):323-328."},{"issue":"3","key":"bib8","series-title":"Acta Anaesthesiol Scand","first-page":"306","article-title":"Effects of dose-dependent levels of isoflurane on cerebral blood flow in healthy subjects studied using positron emission tomography","volume":"50","author":"Schl\u00fcnzen","year":"2006","unstructured":"Schl\u00fcnzen LCold GERasmussen MVafaee MS. Effects of dose-dependent levels of isoflurane on cerebral blood flow in healthy subjects studied using positron emission tomography. Acta Anaesthesiol Scand. 2006;50(3):306-312."},{"issue":"10","key":"bib9","series-title":"Acta Anaesthesiol Scand","first-page":"1268","article-title":"Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study","volume":"48","author":"Schl\u00fcnzen","year":"2004","unstructured":"Schl\u00fcnzen LVafaee MSCold GERasmussen MNielsen JFGjedde A. Effects of subanaesthetic and anaesthetic doses of sevoflurane on regional cerebral blood flow in healthy volunteers. A positron emission tomographic study. 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Acta Anaesthesiol Scand. 2003;47(10):1226-1230."},{"issue":"4","key":"bib12","series-title":"J Neurosurg Anesthesiol","first-page":"288","article-title":"Subanesthetic concentration of sevoflurane increases regional cerebral blood flow more, but regional cerebral blood volume less, than subanesthetic concentration of isoflurane in human volunteers","volume":"13","author":"Lorenz","year":"2001","unstructured":"Lorenz IHKolbitsch CH\u00f6rmann C, et al. Subanesthetic concentration of sevoflurane increases regional cerebral blood flow more, but regional cerebral blood volume less, than subanesthetic concentration of isoflurane in human volunteers. 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Paediatr Anaesth. 2013;23(10):946-951."},{"issue":"2","key":"bib17","series-title":"Eur J Anaesthesiol","first-page":"179","article-title":"Effect of sevoflurane on cerebral blood flow and cerebrovascular resistance at surgical level of anaesthesia: a transcranial Doppler study","volume":"24","author":"Moln\u00e1r","year":"2007","unstructured":"Moln\u00e1r CSettakis GS\u00e1rk\u00e1ny PK\u00e1lm\u00e1n SSzab\u00f3 SF\u00fclesdi B. Effect of sevoflurane on cerebral blood flow and cerebrovascular resistance at surgical level of anaesthesia: a transcranial Doppler study. 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