Posterior Reversible Encephalopathy Syndrome on the Operating Room Table After a Robotic Radical Nephrectomy: A Case Report

Abstract

An elderly patient with renal cell carcinoma underwent a robotic nephrectomy. After an uneventful intraoperative period, soon after extubation she developed generalized seizures and was diagnosed with posterior reversible encephalopathy syndrome (PRES) on neuroimaging. Management included antiepileptic and antihypertensive therapies, necessitating intensive care and neurorehabilitation. This case is noteworthy as it represents the first reported instance of PRES occurring immediately in the operating room after robotic surgery. PRES was attributed to compromised renal function, chronic hypertension, and the effects of pneumoperitoneum. Early diagnosis, aggressive treatment, and rehabilitation are crucial for the management and recovery of patients with PRES.