Abstract
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.
Data availability
Data will become available upon reasonable request. Contact: mariana.gaviria@urosario.edu.co.
References
Hinchey, J. et al. A reversible posterior leukoencephalopathy syndrome. N. Engl. J. Med. 334, 494–500 (1996).
Fischer, M. & Schmutzhard, E. Posterior reversible encephalopathy syndrome. J. Neurol. 264, 1608–1616 (2017).
Hinduja, A., Habetz, K., Raina, S., Ramakrishnaiah, R. & Fitzgerald, R. T. Predictors of poor outcome in patients with posterior reversible encephalopathy syndrome. Int. J. Neurosci. 127, 135–144 (2017).
Granata, G. et al. Posterior reversible encephalopathy syndrome—insight into pathogenesis, clinical variants and treatment approaches. Autoimmun. Rev. 14, 830–836 (2015).
Iftikhar, S. et al. The association of posterior reversible encephalopathy syndrome with COVID-19: a systematic review. Ann. Med. Surg. 72, 103080 (2021).
Lee, V. H., Wijdicks, E. F. M., Manno, E. M. & Rabinstein, A. A. Clinical spectrum of reversible posterior leukoencephalopathy syndrome. Arch. Neurol. 65, 859 (2008).
Gungor, S. et al. Clinical and imaging findings in childhood posterior reversible encephalopathy syndrome. Iran. J. Child. Neurol. 12, 16–25 (2018).
Kozak, O. S., Wijdicks, E. F. M., Manno, E. M., Miley, J. T. & Rabinstein, A. A. Status epilepticus as initial manifestation of posterior reversible encephalopathy syndrome. Neurology 69, 894–897 (2007).
Otite, F. O. et al. Demographic disparities in the Incidence, clinical Characteristics, and outcome of posterior reversible encephalopathy syndrome in the united States. Neurology 101, 5263 (2023).
Mueller-Mang, C. et al. Posterior reversible encephalopathy syndrome: do predisposing risk factors make a difference in MRI appearance? Neuroradiology 51, 373–383 (2009).
Fugate, J. E. et al. Posterior reversible encephalopathy syndrome: associated clinical and radiologic findings. Mayo Clinic Proc. 85, 427–432 (2010).
Lizarazo, J., Tibasosa, D. & Alandete, S. Síndrome de encefalopatía posterior reversible. Acta Neurol. Colombiana 21, 526 (2005).
Heo, K. et al. Development of epilepsy after posterior reversible encephalopathy syndrome. Seizure 34, 90–94 (2016).
Fugate, J. E., Hawkes, M. A. & Rabinstein, A. A. Posterior reversible encephalopathy syndrome: evolving insights in diagnosis, management, and outcomes. Lancet Neurol. 24, 789–800 (2025).
Triplett, J. D., Kutlubaev, M. A., Kermode, A. G. & Hardy, T. Posterior reversible encephalopathy syndrome (PRES): diagnosis and management. Pract. Neurol. (2022).
Chen, Z. et al. Risk factors for poor outcome in posterior reversible encephalopathy syndrome: systematic review and meta-analysis. Quant. Imaging Med. Surg. 8, 421–432 (2018).
Pirola, J. P. et al. Síndrome de leucoencefalopatía posterior reversible: serie de Casos y revisión de La literatura. Reumatol.Clín. 16, 169–173 (2020).
Liman, T. G., Bohner, G., Heuschmann, P. U., Endres, M. & Siebert, E. The clinical and radiological spectrum of posterior reversible encephalopathy syndrome: the retrospective Berlin PRES study. J. Neurol. 259, 155–164 (2012).
Ando, Y., Ono, Y., Sano, A., Fujita, N. & Ono, S. Posterior reversible encephalopathy syndrome: a review of the literature. Intern. Med. 61, 135–141 (2022).
Li, Y., Song, J., Huq, A. M., Timilsina, S. & Gershwin, M. E. Posterior reversible encephalopathy syndrome and autoimmunity. Autoimmun. rev. 22, 103239 (2023).
Tarabichi, A., Ibrahim, F., Abbas, A. & Allam, H. COVID-19 associated posterior reversible encephalopathy syndrome (4617). Neurology 96, 4617 (2021).
Fugate, J. E. & Rabinstein, A. A. Posterior reversible encephalopathy syndrome: clinical and radiological manifestations, pathophysiology, and outstanding questions. Lancet Neurol. 14, 914–925 (2015).
Parasher, A. & Jhamb, R. Posterior reversible encephalopathy syndrome (PRES): presentation, diagnosis and treatment. Postgrad. Med. J. 96, 623–628 (2020).
Garrido, D. et al. Triggers of posterior reversible encephalopathy in Guillain-Barre syndrome. Clin. Neurol. Neurosurg. 198, 106250 (2020).
Fazeli, S., Noorbakhsh, A., Imbesi, S. G. & Bolar, D. S. Cerebral perfusion in posterior reversible encephalopathy syndrome measured with arterial spin labeling MRI. NeuroImage: Clin. 35, 103017 (2022).
Noro, F., De Mendonça Cardoso, F. & Marchiori, E. COVID-19 and posterior reversible encephalopathy syndrome. Neur. Clin. Pract. 11, 5263 (2021).
Park, S., Anwar, A., Saleem, S. & Ali, I. Meta-analysis of EEG findings in patients with PRES (P14-8.005). Neurology 98, 2051 (2022).
Cozzolino, M. et al. Therapy and differential diagnosis of posterior reversible encephalopathy syndrome (PRES) during pregnancy and postpartum. Arch. Gynecol. Obstet. 292, 1217–1223 (2015).
Prasad, P. Status epilepticus as a presenting feature in posterior reversible encephalopathy syndrome: tertiary care center experience. Indian J. Crit. Care Med. 27, 488–492 (2023).
Seitz, A. et al. Abstract WP155: epidemiology of posterior reversible encephalopathy syndrome (PRES) in the United States: a National inpatient sample study. Stroke 55, 2563 (2024).
Amornpojnimman, T. et al. Predictors of hospital outcomes among patients with posterior reversible encephalopathy syndrome. J. Stroke Cerebrovasc. Dis. 31, 106579 (2022).
Schweitzer, A. D. et al. Imaging characteristics associated with clinical outcomes in posterior reversible encephalopathy syndrome. Neuroradiology 59, 379–386 (2017).
Acknowledgements
We want to thank Loren Gallo NR from Hospital Universitario Mayor Méderi, Bogotá, Cundinamarca, Colombia for her support during this study.
Funding
No funding was received for conducting this study.
Author information
Authors and Affiliations
Contributions
Mónica Juliana Ortiz Pereira: Conceptualization, Methodology, Investigation, Data Curation, Writing - Original Draft, Writing - Review & Editing, Visualization. Mariana Gaviria-Carrillo : Investigation, Writing - Original Draft, Writing - Review & Editing, Supervision. Isabella Esther Mendoza-Rodelo : Investigation, Writing - Original Draft, Writing. Sofía Ramírez-Guerrero: Investigation, Formal analysis, Writing - Original Draft, Writing - Review & Editing. María Alejandra Palacios : Formal analysis, Writing - Original Draft, Visualization. Luis Roa: Investigation, Conceptualization, Supervision. Jesús Rodriguez: Investigation, Conceptualization, Supervision. Camilo Romero: Conceptualization, investigation, Methodology, Writing - Review & Editing, Supervision.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethics approval
This study was revised and approved by the following ethical committees: Comité Técnico de Investigaciones CIMED - Hospital Mayor Méderi and Comité de Investigaciones de la Fundación Cardioinfantil – Instituto de Cardiología.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Ortiz-Pereira, M., Gaviria-Carrillo, M., Mendoza-Rodelo, I.E. et al. Posterior reversible encephalopathy syndrome in Colombia a case series. Sci Rep (2026). https://doi.org/10.1038/s41598-026-38921-w
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-38921-w
