Cronicon OPEN ACCESS EC CLINICAL AND MEDICAL CASE REPORTS EC CLINICAL AND MEDICAL CASE REPORTS Case Report Posterior Reversible Encephalopathy Syndrome (PRES) Aboud AlJabari* Consultant Cardiothoracic, Regional Anesthesia and Pain Medicine, Lausanne University hospital, Switzerland Citation: Aboud AlJabari. “Posterior Reversible Encephalopathy Syndrome (PRES)”. EC Clinical and Medical Case Reports 6.5 (2023): 64-66. *Corresponding Author: Aboud AlJabari, Consultant Cardiothoracic, Regional Anesthesia and Pain Medicine, Lausanne University hospital, Switzerland. Abstract 63 year old diabetic patient with pancreatic tumor underwent Whipple procedure developed confusion and blindness postopera- tively diagnosed with posterior reversible encephalopathy syndrome. Keywords: Blindness; Postoperative; Encephalopathy; Anesthesia Received: March 20, 2023; Published: April 29, 2023 Abbreviations mg: Milligram; Mcg: Microgram; Kg: Kilogram; ASA: American Society of Anesthesiologist; %: Percentage; BP: Blood Pressure; HR: Heart Rate; Min: Minute; RPLS: Reversible Posterior Leukoencephalopathy Syndrome; PRES: Posterior Reversible Encephalopathy Syndrome; MRA: Magnetic Resonance Arterial; MRV: Magnetic Resonance Venous; MRI: Magnetic Resonance Imaging; CT: Computed Tomography; ICU: Intensive Care Unit Introduction Posterior Reversible Encephalopathy Syndrome (PRES) is typically reversible once the cause is removed or treated, but permanent neurological impairment or death occurs in a minority of patients. Case Report A 53 year old male patient, weighed 70 Kg, ASA 2, known case of diabetes mellitus. He was diagnosed with non-Hodgkin lymphoma treated with chemotherapy protocol, his last chemotherapy session was in 2022. Patient was previously anesthetized without any complications. Patient was diagnosed with pancreatic head tumor and was planned for Whipple procedure. Patient’s preoperative vital signs: BP: 130/70, HR: 60/min, SpO 2 : 99%. Anesthesia was induced with: Fentanyl 150 mcg, propofol 120 mg, cisatracurium 12 mg. Anesthesia was maintained using isoflurane 1 vol. % and remifentanil 0.5 mcg/kg/min. Invasive monitoring of central line and arterial line were inserted. Nasogastric tube secured and temperature was measured all through the operation. Duration of surgery was 6 hours; he was given 5 liters crystalloids intravenously. The estimated blood loss was around 500 mL with adequate urine output. He was extubated and observed in ICU. He complained from pain and was given morphine 5 mg.