# Posterior Reversible Encephalopathy Syndrome Caused by Renovascular Hypertension in a Solitary Functioning Kidney: Successful Treatment With Renal Artery Stenting

## TL;DR

An elderly woman with a single functioning kidney developed neurological symptoms due to severe hypertension caused by kidney artery blockage, which was successfully treated with a stent.

## Contribution

This case highlights renovascular hypertension as a reversible cause of PRES in patients with a solitary kidney.

## Key findings

- The patient's PRES was linked to renovascular hypertension in a solitary functioning kidney.
- Renal artery stenting stabilized blood pressure and resolved neurological symptoms.
- The case emphasizes the importance of diagnosing renovascular causes in PRES patients with marked hypertension.

## Abstract

Posterior reversible encephalopathy syndrome (PRES) can develop in the setting of severe hypertension and may present with seizures and altered consciousness. We report the case of an 81-year-old woman who presented with impaired consciousness and generalized seizures during a hypertensive crisis. Brain magnetic resonance imaging revealed bilateral parieto-occipital subcortical hyperintensities. Diagnostic imaging revealed severe proximal stenosis of the right renal artery, complete occlusion of the left renal artery, and marked atrophy of the left kidney, suggesting renovascular hypertension due to renal artery stenosis in a solitary functioning kidney. Based on these findings, PRES secondary to renovascular hypertension was diagnosed, and percutaneous renal angioplasty was performed, resulting in stabilization of blood pressure and resolution of neurological symptoms. This case highlights the importance of considering renovascular hypertension as a reversible cause of PRES, especially in patients with a solitary kidney and marked blood pressure elevation and variability.