Posterior reversible encephalopathy syndrome in Colombia a case series

Posterior Reversible Encephalopathy Syndrome (PRES) is a rare clinical and radiological condition. There is limited information regarding the characteristics of PRES in the Colombian population. This study aims to describe the clinical-radiological characteristics of PRES in a series of cases in Colombia. A retrospective study was conducted between 2018 and 2024 with adult patients with PRES in two high complexity centers in Bogota, Colombia. Demographic, clinical, radiological, electroencephalographic, neurological complications and clinical outcomes were registered. Comparison of outcomes was performed between patients with and without neurological complications (ischemia, hemorrhage, or status epilepticus). A bivariate logistic regression analysis was performed to determine the risk factors associated with neurological complications of PRES. We included 60 patients with a median age of 55 years, 68.3% women. The most frequent risk/triggering factor was high systemic blood pressure (55%). Main symptoms reported were seizures (73.3%), impaired consciousness (60%), headache (43.3%) and visual changes (36.6%). Vasogenic cerebral edema was more common in the occipito-parietal region (33.3%). No fatalities were reported. The most frequent neurological complication was intracranial hemorrhage. Absence of complications was associated with shorter hospital stay (6 vs. 14 days). Additionally, a history of cerebrovascular disease and decreased visual acuity at presentation were associated with a lower observed rate of neurological complications following PRES (OR 0.1; 95% CI 0.01–0.91). Clinical-radiological characteristics of PRES in the Colombian population studied are similar to those described in literature. In our analysis, a history of cerebrovascular disease and decreased visual acuity at presentation were associated with a lower observed rate of neurological complications following PRES.