Fig 2.

The patient is a 38-year-old woman with scleroderma, severe hypertension (190/110 mm Hg), and acute renal failure, with altered mental status that progressed to seizure. A, Axial brain CT image obtained at toxicity demonstrates vasogenic edema in the parietal region bilaterally (curved arrows), consistent with PRES. B, Axial technetiumTc-99m-HMPAO SPECT study performed the following day demonstrates reduced radiopharmaceutical uptake bilaterally in the parietal region (curved arrows), consistent with hypoperfusion.