The Overlap of Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome: A Report of a Complex Case and Challenges With Its Management.

We report the case of a 38-year-old female presenting with posterior reversible encephalopathy syndrome (PRES) overlapping with reversible cerebral vasoconstriction syndrome (RCVS), diagnosed based on clinical and imaging criteria. The patient exhibited progressive neurological symptoms, including headache, visual disturbances, and motor deficits. Brain magnetic resonance angiography revealed vasogenic edema and vascular stenoses. The complications included severe agitation, sympathetic hyperreactivity, and features suggestive of serotonin syndrome. The management focused on blood pressure control, symptom management, and medication adjustment. Despite significant improvement during hospitalization and rehabilitation, residual deficits persisted. This report highlights the complex interplay between PRES and RCVS, emphasizing the importance of serial neuroimaging, systematic medication reviews, and a multidisciplinary approach in managing such overlapping conditions.