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Record W4413007827 · doi:10.1097/ms9.0000000000003676

Intracranial hemorrhage in posterior reversible encephalopathy syndrome: a systematic review & meta-analysis

2025· review· en· W4413007827 on OpenAlexaboutno aff
Bahadar S. Srichawla, Mihnea‐Alexandru Găman, Hande Can, Vincent Kipkorir, Maria A. García‐Dominguez

Bibliographic record

VenueAnnals of Medicine and Surgery · 2025
Typereview
Languageen
FieldMedicine
TopicNeurological Complications and Syndromes
Canadian institutionsnot available
Fundersnot available
KeywordsMedicinePosterior reversible encephalopathy syndromeHeadachesSubarachnoid hemorrhageIncidence (geometry)CohortIntraparenchymal hemorrhagePediatricsMortality rateInternal medicineSurgeryMagnetic resonance imagingRadiology

Abstract

fetched live from OpenAlex

Background: Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiographic phenomenon characterized by vasogenic edema, predominantly affecting the posterior regions of the brain. The hemorrhagic variant of PRES has been increasingly recognized, complicating the clinical picture and prognosis. Methods: This meta-analysis was conducted in accordance with PRISMA guidelines. Observational studies, case reports/series were included. Extracted data included demographics, clinical presentations, imaging findings, and outcomes. A random-effects model to pool the incidence rate of hemorrhagic PRES, and heterogeneity was assessed using the I 2 statistic. The Joanna Briggs Institute scale for case reports/series and the New Castle Ottawa scale for cohort studies were used for quality and risk of bias assessment. Results: A total of 63 individual records and 12 cohort studies were reviewed. Hypertension at arrival was seen in > 90% of cases. 60.3% of cases occurred in women and the average age was 39.3, with a 12.7% mortality rate. The incidence rate of hemorrhagic PRES was found to be approximately 17%, with significant heterogeneity among the included studies (I 2 = 67%). Seizures (31.7%), headaches (33.3%), and altered mental status (30.1%) were the most reported symptoms. Hypertension (31.7%), immunosuppressive therapy (23.8%), and coagulopathy (11.1%) were identified as the most common risk factors. Hemorrhagic findings included intraparenchymal hemorrhage (77.7%), subarachnoid hemorrhage (15.8%), and microhemorrhages (6.3%). Conclusions: Hemorrhagic PRES is a significant clinical concern, occurring in approximately 17% of PRES cases and is often associated with poorer outcomes. We highlight the importance of early recognition, aggressive blood pressure control, and careful monitoring in high-risk patients.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.003
metaresearch head score (Gemma)0.003
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesMeta-epidemiology (narrow), Meta-epidemiology (broad)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Systematic review · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.592
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0030.003
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0170.003
Bibliometrics0.0020.003
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.269
GPT teacher head0.414
Teacher spread0.145 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designSystematic review
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations0
Published2025
Admission routes1
Has abstractyes

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