First description of posterior reversible encephalopathy syndrome as a complication of glycerolnitrate patch following open cardiac surgery.

Kuhn AL, Huch B, Wendt G, Dooms G, Droste DW. First description of posterior reversible encephalopathy syndrome as a complication of glycerolnitrate patch following open cardiac surgery. Acta Neurol Scand: 2011: 124: 218–220. © 2010 John Wiley & Sons A/S. Background–  Posterior reversible encephalopathy syndrome (PRES) affects predominantly the parietal and occipital lobes. Frequent clinical features are epileptic seizure, altered mental status and visual disturbances. Clinical Presentation –  We present the first case of a patient with pericarditis and mitral valve insufficiency, who developed PRES after application of a glycerolnitrate patch day three post-operatively and whose neurological deficits improved within 2 days after withdrawal of patch therapy. Conclusion –  The precise pathomechanism of PRES is unknown. The lower sympathetic innervation of the posterior circulation may be one explanation for its particular vulnerability to vasodilatation caused by glycerolnitrate.