Patient 8 is a 55-year-old woman with multiple liver metastases from renal cell carcinoma who underwent liver wedge resection and intraoperative chemotherapy.

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Presentation transcript:

Patient 8 is a 55-year-old woman with multiple liver metastases from renal cell carcinoma who underwent liver wedge resection and intraoperative chemotherapy infusion. Patient 8 is a 55-year-old woman with multiple liver metastases from renal cell carcinoma who underwent liver wedge resection and intraoperative chemotherapy infusion. Baseline blood pressure was 115/70 mm Hg. She developed ARDS and Streptococcus pneumoniae sepsis 3 days after resection followed by pneumonia (S aureus) and line sepsis (coagulase-negative staphylococci). Patient developed altered mental status 3 days after pneumonia and bacteremia with blood pressure at toxicity of 150/80 mm Hg.A-C, Brain CT images obtained at toxicity demonstrate vasogenic extensive edema in the occipital (open arrows), parietal (curved arrows), and frontal regions (arrows) bilaterally with focal edema also noted in the anterior limb internal capsule bilaterally (arrowheads) consistent with PRES with ventricular compression and deformity from the edema judged grade 5.D, Follow-up brain CT imaging performed 1 month after initial imaging demonstrates complete reversal of the PRES pattern shown here in the parietal (curved arrows) and frontal (arrows) regions bilaterally. W.S. Bartynski et al. AJNR Am J Neuroradiol 2006;27:2179-2190 ©2006 by American Society of Neuroradiology