enalapril and Precursor-B-Cell-Lymphoblastic-Leukemia-Lymphoma

Posterior reversible encephalopathy syndrome (PRES) and cerebral sinus thrombosis are 2 known complications of acute lymphoblastic leukemia and its treatment. We describe a patient with acute lymphoblastic leukemia whose course was complicated by both of these conditions. This case is novel both for the fact that PRES developed before the initiation of therapy and that PRES was followed shortly by the development of cerebral sinus thrombosis. Our patient's story raises questions about our current understanding of the pathophysiology of PRES, and it suggests that PRES may actually be a predisposing risk factor for cerebral sinus thrombosis.

Topics: Antineoplastic Combined Chemotherapy Protocols; Brain Ischemia; Cerebral Infarction; Child, Preschool; Enalapril; Enoxaparin; Female; Humans; Intracranial Hypertension; Magnetic Resonance Imaging; Neuroimaging; Occipital Lobe; Papilledema; Parietal Lobe; Posterior Leukoencephalopathy Syndrome; Precursor B-Cell Lymphoblastic Leukemia-Lymphoma; Remission Induction; Sinus Thrombosis, Intracranial