Purpose: to determine the distribution and incidence of atypical regions of involvement of PRES in eclapmtic patients by using MR imaging.

Material and Methods: A prospective study included Twenty Two registered eclamptic patients (age ranged from 20–38 years) who had clinical signs and symptoms of PRES were recruited in the study, all patients were referred from Gynecology and Obstetric department, for brain MRI to evaluate PRES after clinical suspiscion. All images were reviewed for the presence of high signal intensity on FLAIR and T2WI, for the severity of the vasogenic brain edema, on the basis of the extent of hyperintensity on FLAIR imaging. DWI were also interpreted for the presence or absence of areas of restricted diffusion corresponding to the hyperinternsity areas on T2WI and FLAIR images.

Results: Most commonly involved location was the parietooccipital brain region, which was seen in 19 (86.3%) of the (22) patients. This was followed by the frontal lobe in 13 patients (59%), the temporal lobe in 3 (13.6%), Basal Ganglia in 3 patients and cerebellum in 3 patients. Restricted diffusion was present in 9 patients (40.9%), half of patients had moderate edema (n= 11) while only 2 patients had severe edema and 9 had mild edema. Conclusion: PRES can affect anterior circulation structures and atypical regions fairly frequent than commonly known. However, a posterior predominance is certainly seen in each lobe, Atypical regions of involvement represents challenge for radiologist and necessitate strict clinical correlation and follow up. http://dx. doi. org/10.1016/j. ijdevneu. 2015.04. 180