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Hubbard ME, Phillips AA, Charbonneau R, Squair JW, Parr AM, Krassioukov A. PRES secondary to autonomic dysreflexia: A case series and review of the literature. J Spinal Cord Med 2021; 44:606-612. [PMID: 31140946 PMCID: PMC8288129 DOI: 10.1080/10790268.2019.1616146] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Context: Autonomic dysreflexia (AD) is a complex syndrome seen in patients with spinal cord injuries (SCI) and can be life-threatening with a significant negative impact on the health of the individual. Posterior reversible encephalopathy syndrome (PRES) is thought to be caused, in part, by rapid elevations in blood pressure; leading to posterior cerebral circulatory edema. This can result in seizures, blindness and can progress to fatal intracranial hemorrhages.Findings: Here we present two cases of patients with SCI who developed PRES from AD. Each patient was correctly diagnosed, leading to appropriate treatment of the factors leading to their AD and subsequent resolution of their PRES symptoms.Conclusions/Clinical Relevance: In SCI patients who present with new seizures, visual deficits, or other neurologic signs, PRES should be considered as a part of the differential diagnosis as a good outcome relies on rapid recognition and treatment of AD.
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Affiliation(s)
- Molly E. Hubbard
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA,Correspondence to: Molly E. Hubbard, Department of Neurosurgery, University of Minnesota, MMC 96 Room D-429, Mayo Building, 420 Delaware St SE, Minneapolis, MN55455, USA; Ph: 612-624-6666.
| | - Aaron A. Phillips
- Departments of Physiology and Pharmacology and Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Rebecca Charbonneau
- Department of Physical Medicine and Rehabilitation, University of Alberta, Calgary, AB, Canada
| | - Jordan W. Squair
- Department of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada
| | - Ann M. Parr
- Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA
| | - Andrei Krassioukov
- Department of Physical Medicine and Rehabilitation, University of British Columbia, Vancouver, BC, Canada
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Chen F, Guo H, Mao C, Jiang X, Liu S, Huang L, Wei X, Liang Z, Zhou D, Li W. Unusual Relapse of Primary Central Nervous System Lymphoma Both Inside and Outside Central Nervous System in Patient with Ventriculoperitoneal Shunt. World Neurosurg 2019; 127:625-628. [PMID: 30794971 DOI: 10.1016/j.wneu.2019.01.277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Revised: 01/27/2019] [Accepted: 01/30/2019] [Indexed: 12/01/2022]
Abstract
BACKGROUND Relapse of primary central nervous system (CNS) lymphoma (PCNSL) occurs primarily at the initial site. Relapse outside the CNS is rare. CASE DESCRIPTION We present the case of a 62-year-old immunocompetent man who underwent a stereotactic biopsy to diagnose PCNSL and subsequent placement of ventriculoperitoneal shunt (VPS) for symptom relief in November 2012. He got complete remission after 6 cycles of high-dose methotrexate-based chemotherapy. In August 2017, relapse of lymphoma occurred in the abdomen, left basal ganglia, and bilateral ventricle with the largest lesion being around the VPS in the abdomen. He got complete remission after 6 cycles of R-CHOP (rituximab, cyclophosphamide, epirubicin, vincristine and prednisolone) plus 8 cycles of high-dose methotrexate chemotherapy. CONCLUSIONS Here we report the first case of extra-CNS relapse of PCNSL around the site of VPS in the abdomen after intensive chemotherapy. Neurosurgeons should be aware of a potential risk of PCNSL spread along the VPS.
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Affiliation(s)
- Feili Chen
- Lymphoma Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Hanguo Guo
- Lymphoma Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Chengliang Mao
- Neurosurgery Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Xinmiao Jiang
- Lymphoma Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Sichu Liu
- Lymphoma Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Ling Huang
- Lymphoma Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Xiaojuan Wei
- Lymphoma Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Zhanli Liang
- Lymphoma Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Dong Zhou
- Neurosurgery Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China
| | - Wenyu Li
- Lymphoma Division, Guangdong General Hospital, Guangdong Academy of Medical Science, Guangzhou, Guangdong, China.
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