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 enhancement 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 reports.