Two similar cases of encephalopathy, possibly a reversible posterior leukoencephalopathy syndrome: serial findings of magnetic resonance imaging, SPECT and angiography

Intern Med. 1999 Jan;38(1):54-8. doi: 10.2169/internalmedicine.38.54.


Two young women who had encephalopathy that resembled reversible posterior leukoencephalopathy syndrome are presented. The brain magnetic resonance imaging (MRI) of these patients exhibited similar T2-high signal lesions, mostly in the white matter of the posterior hemispheres. Xe-SPECT during the patients' symptomatic period showed hypoperfusion in the corresponding areas, and angiography demonstrated irregular narrowing of the posterior cerebral artery. Clinical manifestations subsided soon after treatment, and the abnormal radiological findings also were almost completely resolved. Thus, we concluded that transient hypoperfusion followed by ischemia and cytotoxic edema might have had a pivotal role in these cases.

Publication types

  • Case Reports
  • Comparative Study

MeSH terms

  • Adult
  • Brain Diseases / complications
  • Brain Diseases / diagnosis*
  • Brain Diseases / drug therapy
  • Brain Edema / diagnosis
  • Brain Edema / etiology
  • Cerebral Angiography*
  • Cerebral Arteries / diagnostic imaging
  • Female
  • Fibrinolytic Agents / therapeutic use
  • Follow-Up Studies
  • Humans
  • Magnetic Resonance Imaging*
  • Occipital Lobe / blood supply*
  • Occipital Lobe / diagnostic imaging
  • Syndrome
  • Tomography, Emission-Computed, Single-Photon*


  • Fibrinolytic Agents