POSTERIOR REVERSIBLE ENCEPHALOPATHY SYNDROME (PRES) ASSOCIATED WITH CEREBRAL MICROBLEEDS IN A CHILD WITH SEVERE ACUTE ASTHMA: A CASE REPORT

Background: Posterior Reversible Encephalopathy Syndrome (PRES) is a rare clinico-radiological entity characterized by signal abnormalities predominantly involving the posterior cortico-subcortical regions. Its association with severe asthma exacerbation and cerebral microbleeds represents an exceptionally rare clinical presentation, especially in pediatric patients. Case Presentation: We report the case of a 14-year-old girl with a history of asthma admitted to the pediatric intensive care unit for severe acute asthma exacerbation complicated by refractory status epilepticus. Brain MRI revealed bilateral fronto-parieto-occipital FLAIR hyperintensities consistent with PRES, associated with multiple cerebral microbleeds involving the corpus callosum and white matter, as well as a small subacute hematoma of the left cerebral peduncle. The patient improved under anticonvulsant therapy and intensive management of severe acute asthma. Conclusion: This case highlights the importance of considering PRES in any asthmatic patient presenting neurological manifestations in the intensive care setting. Cerebral microbleeds represent a serious complication requiring close neuroradiological follow-up.