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. 2023 Oct 18;86(3):1251–1260. doi: 10.1097/MS9.0000000000001407

Table 3.

Results of the systematic review of cases of PRES and RCVS after vaccination.

Case no. Diagnosis Age Sex Risk factors Symptoms Vaccine type Time to onset Imaging findings Treatment Outcomes
1 PRES 76 F Hypertension, alcohol use disorder, shingles Confusion, blurry vision, unsteady intermittent gait COVID-19 mRNA (Moderna) <24 h T2/FLAIR hyperintensities in the parieto-occipital lobes levetiracetam 750 mg twice daily Residual cognitive decline 18 months later
2 PRES 18 F None Diffuse pain, pruritus, weakness of the hand, dysthesia Measles 8 h T2/FLAIR hyperintensities in the occipital lobes 1000 mg steroids for 3 days. MRA showed vasoconstriction of the posterior cerebral arteries Improvement in T2/FLAIR hyperintensities and posterior circulation vasoconstriction after 3 days of treatment
3 RCVS 30 M History of RCVS, Bipolar disorder Thunderclap headache COVID-19 mRNA (Pfizer) 12 h Normal CT head Losartan 50 mg for 2 weeks No symptoms at 2-week follow-up
4 RCVS 38 F Migraine without aura, 10-pack smoking history Sudden-onset blurred vision bilaterally followed by a focal headache over the right occipital projection COVID-19 mRNA (Moderna) 18 days MRI showed an ischemic stroke on the territory of the right posterior cerebral artery. MRA shows discontinuation of the right P1 segment Levetiracetam (1000 mg/d) and nimodipine (90 mg/d) for 5 weeks Normal flow in both PCAs was documented on CTA after 7 days of nimodipine, suggesting vasospasm

COVID-19, Coronavirus disease 2019; MRA, Magnetic resonance angiography; PRES, Posterior reversible encephalopathy syndrome; RCVS, Reversible cerebral vasoconstriction syndrome.