Typical and atypical features in Posterior Reversible Encephalopathy Syndrome (PRES)

Posterior reversible encephalopathy syndrome (PRES) is a reversible clinico-radiological condition with different etiologies. The typical findings are symmetric involvement of the parieto-occipital and posterior frontal cortex with sub-cortical white matter. But brain stem, basal ganglia and cerebellum can be involved as well. It sometimes progresses to atypical appearances including hemorrhage, contrast en-hancement or diffusion weighted restriction. In this report, we introduce a young man who developed PRES after substance abuse with both typical and atypical features in the supra- and infra- tentorium areas and deep zones of the brain in magnetic resonance imaging. Involvement of all these areas of the brain together (supra- and infra- tentorium and deep parts) is uncommon in re-ports.