Review for 10.1186/s12876-021-02069-w (2021)

Reviewer’s report
Title: 
The first two cases of posterior reversible encephalopathy syndrome
(PRES) secondary to conventional transcatheter arterial chemoembolization of
hepatocellular carcinoma: case report
Version: 
1 
Date: 
15 Nov 2021
Reviewer's report:
SPECIFIC COMMENTS
This manuscript is pleasurable and flowing, in general; no major issues are
appreciable. 
Although language used is appropriate, I (I am not a native English speaker)
recommend to Authors to obtain a certified native speaker with proficiencies in
the scientific-medical field to complete properly this paper (if not jet done).
Moreover, I recommend making a further revision of the manuscript to fix some
typing/language errors. For example: "Background, page 3, lines 16-18: …
mestatic….Did the authors means metastatic?
TITLE
The title is clear and direct. Personally, I believe it could be improved, for
example: "The fists two cases of posterior reversible encephalopathy syndrome
(PRES) secondary to conventional transcatheter arterial chemoembolization for
of hepatocellular carcinoma: case report". If the editor agrees, the authors could
consider the change of the title.
ABSTRACT
The abstract is well structured in background and case presentation and,
therefore, it properly reflects the main text, highlighting the most important
aspects of this paper. However, some adjustments are needed I conclusion. The
evidence reported in the conclusion is too strong if related to the nature of the
present study. It could be re-phrased.
KEYWORDS
Authors did not correctly report all keywords from MeSH Browser. In particular,
for example, I checked "Case report" on MeSH Browser and I did not find this
KW. This is important, in my personal opinion, in order to increase the
traceability of this paper (and consequently the possibility of the Journal to be
cited by Readers and Stakeholders). I suggest the check of the all KWs.
CASE PRESENTATION
The Authors did not explain which kind of chemoembolisation they used
(according to which scheme? EASL? Ann Hepatol. 2021 May-Jun;22:100278.
doi: 10.1016/j.aohep.2020.10.006. Epub 2020 Oct 29. PMID: 33129978.?).
In the first case they introduced 5-fluorouracil and calcium folinate before doxo.
In the second case they introduced oxaliplatin. Why this difference? How can the
authors exclude the role of chemotherapic injected without carrier? Please
discuss this point.
Please, could the authors describe in brief, their scheme of injection of
chemotherapic in the artery?
Please, could the authors report the fluoroscopy time according to [Med Phys.
2012 May;39(5):2491-8. doi: 10.1118/1.3702457. PMID: 22559619], to
understand if this event is stochastic? This is the first two cases of PRES after
cTACE for HCC, and therefore it is important in my opinion to introduce also
this point, citing the aforementioned paper.
Please, could the authors quantitatively report the post-treatment transient
transaminase elevations according to [J Pers Med. 2021 Oct 17;11(10):1041. doi:
10.3390/jpm11101041. PMID: 34683182; PMCID: PMC8539564.], in order to
understand if the hepatic necrosis plays a potential rule in the genesis of PRES.
A simple curiosity: have the patients the patency of the foramen ovale?
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Is the study design appropriate to answer the research question (including the use
of appropriate controls), and are the conclusions supported by the evidence
presented?
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from apparent manipulation?
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