Pediatric PRES with Spinal Cord Involvement Due to Pheochromocytoma

Publication date: Available online 12 July 2017
Source:Pediatric Neurology
Author(s): Daniel Freedman, Abena Koram, Natalie Gillson, Shawn C Aylward
IntroductionPosterior reversible encephalopathy syndrome (PRES) is most commonly caused by systemic hypertension or drug effects. However other, less common etiologies exist, so a thoughtful evaluation is indicated in any patient.Patient DescriptionA 12-year-old boy presented with subacute headache, blurred vision, vomiting and right paresthesias. He was hypertensive with MRI evidence of PRES involving the brain parenchyma and spinal cord. MRI of the thoracic spine also revealed a mass on the upper pole of the right kidney. Pathology of the tumor revealed a pheochromocytoma. Repeat neural axis imaging showed complete resolution of abnormalities after surgical resection of the tumor and blood pressure normalization.ConclusionsThis patient highlights a unique distribution and etiology for PRES . Not only did he have typical parenchymal PRES lesions of the brain but also abnormal signal throughout the spinal cord, which has not before been described. This is the first case of pediatric PRES with spinal cord involvement secondary to a pheochromocytoma.



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