A 55-year-old man with poorly controlled hypertension presents with sudden severe occipital headache, confusion, and vision loss. Vital signs show BP 210/130 mmHg, HR 92/min, RR 18/min, temperature 37.2°C. Examination reveals papilledema and retinal hemorrhages; fundoscopy shows no focal deficits. Serum creatinine is 2.1 mg/dL. Brain MRI demonstrates multifocal areas of cerebral edema without acute infarction. Which of the following is the most likely diagnosis?
- A)Posterior reversible encephalopathy syndrome (PRES)GABARITO
- B)Acute angle-closure glaucoma
- C)Hemorrhagic stroke with secondary edema
- D)Acute coronary syndrome with cardiogenic shock
- E)Bacterial meningitis with sepsis
Explicação
PRES presents with severe hypertension, headache, vision loss, altered mental status, and characteristic parietal-occipital white matter edema on MRI. It results from hypertensive crisis overwhelming cerebrovascular autoregulation, causing vasogenic edema that... Ver explicação completa e trilha adaptativa →