It may be that the oedema is due to sudden compromise of blood supply due to vasoconstriction, leading to disruption of the blood brain barrier. Given this is a vasoconstriction rather than a thrombosis, it should be reversible. However, in practice I have seen one case of permanent blindness with PRES in a young female with lupus. It was the first diagnosis of lupus in that young woman with a prior diagnosis of 'ITP' when she presented with refractory seizures. Imaging while in the ITU suggested PRES but upon extubation and regaining consciousness, she was diagnosed with cortical blindness. Now more than 4 months into her follow-up, she is in remission with immunosuppression but her vision is perception of light only.

The complexities surrounding atypical PRES are indeed fascinating and highlight the importance of understanding the underlying mechanisms. While vasoconstriction seems to play a central role in the pathophysiology, the exceptions, like the case of the young woman with lupus, remind us of the unpredictability in clinical outcomes. It's crucial for healthcare professionals to stay informed about advancements in technology that can aid in patient education and management. For instance, innovative tools like the spinmama casino app could potentially offer new avenues for patient engagement and support here in Austria.