Transient Cortical Blindness After Renal Angioplasty: Posterior Reversible Encephalopathy Syndrome After Renal Stenting.

BACKGROUND

Posterior reversible encephalopathy syndrome (PRES) is a rare but well-recognized clinical-radiological entity, most commonly associated with hypertension, renal failure, immunosuppression, or pre-eclampsia.

CASE SUMMARY: We describe a 41-year-old man with refractory hypertension who underwent renal artery angioplasty for severe unilateral renal artery stenosis. Within 30 minutes of the procedure, the patient developed bilateral cortical blindness, with no other lateralizing features. Brain imaging revealed features consistent with PRES. Over 10 days, the patient recovered fully without specific intervention beyond supportive care.

DISCUSSION: PRES is a rare but important differential diagnosis in patients with neurological symptoms after endovascular procedures. Awareness of this potential complication can guide conservative management and avoid unnecessary treatment escalation.

TAKE-HOME MESSAGE: PRES should be included in the differential diagnosis of acute neurological symptoms after interventional procedures, particularly in patients with underlying hypertension or renal dysfunction.