Studying the evolution and the magnetic resonance findings of reversible posterior leukoencephalopathy in children.

PURPOSE: To describe the evolution and the magnetic resonance imaging (MRI) findings of the reversible posterior leukoencephalopathy (RLPS) in children.

METHOD: Nine children with neurologic symptoms and sudden increase of the arterial pressure were studied by brain MRI.

RESULTS: All children evaluated had lesions seen on FLAIR-weighted images of the parietal-occipital regions. Other regions were also involved. Four patients presented restriction on diffusion-weighted images and only two with reduction of the apparent diffusion coefficient (ADC), which evolved with neurologic sequels and persistence of the lesions on the control examination. The other patients had complete regression of the lesions after therapy.

CONCLUSION: MRI is important to suggest the diagnosis of RPLS in patients with arterial hypertension and unspecific neurologic symptoms. Moreover, the outcome is not favorable all the time and the association of D-WI with ADC can be an instrument capable of predicting irreversible lesions.