Posterior Reversible Encephalopathy Syndrome Associated With a Pontine Lacunar Infarct in a Severely Hypertensive Patient: A Case Report

Posterior reversible encephalopathy syndrome (PRES) is a neurologic condition defined by symptoms and imaging findings secondary to vasogenic edema in the brain. Even though not all hypertensive individuals will progress to PRES, high blood pressure is the most frequent risk factor associated with the condition. The pathophysiology of PRES is not clearly understood, but the most accepted proposed mechanism focuses on the brain's inability to regulate cerebral blood flow through constriction or dilation of vessels during extreme blood pressure. This case report is about a 38-year-old male patient who presented to the hospital complaining of a headache and was found to have severe hypertension associated with PRES and a pontine infarct. The epidemiology, etiology, pathophysiologic mechanism, clinical presentation, radiologic findings, management, and prognosis of PRES syndrome are discussed.