Download PDF
CC BY-NC-ND 4.0 · Indian J Med Paediatr Oncol 2011; 32(04): 211-213
DOI: 10.4103/0971-5851.95143
CASE REPORT

Isolated cerebellar involvement in posterior reversible encephalopathy syndrome in a child with acute lymphoblastic leukemia

Narendra Chaudhary
Department of Pediatrics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
,
Rubeena Majeed
Department of Radiodiagnosis, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
,
Anupama Borker
Department of Pediatrics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
› Author Affiliations
› Further Information
  PDF Download Permissions and Reprints

Abstract

Parieto-occipital region is the most commonly involved site in posterior reversible encephalopathy syndrome (PRES). Cerebellar involvement has been reported with the predominant involvement of posterior cerebral regions, but isolated cerebellar involvement in PRES has been reported only once in English literature. We report here a 7-year-old boy with acute lymphoblastic leukemia who had PRES with isolated cerebellar involvement during induction chemotherapy. He presented with sudden onset headache, vomiting and hypertension followed by seizures, unconsciousness, and involuntary movements. Computed tomography scan revealed bilateral cerebellar hypodensities. He improved within few hours and reversibility of the lesions was documented on magnetic resonance imaging after 2 weeks. Awareness of atypical patterns in distribution of imaging abnormalities is important to recognize PRES more accurately and to avoid unnecessary diagnostic procedures and treatment.

Keywords

Isolated cerebellar involvement - posterior reversible encephalopathy - reversible occipito-parietal leukoencephalopathy


Publication History

Article published online:
06 August 2021

© 2011. Indian Society of Medical and Paediatric Oncology. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Soysal DD, Caliskan M, Aydin K, Nayir A, Karaböcüoglu M, Citak A, et al. Isolated cerebellar involvement in a case of posterior reversible leukoencephalopathy. Clin Radiol 2006;61:983-6.
  • 2 Pavlakis SG, Frank Y, Chusid R. Hypertensive encephalopathy, reversible occipitoparietal encephalopathy, or reversible posterior leukoencephalopathy: Three names for an old syndrome. J Child Neurol 1999;14:277-81.
  • 3 Bartynski WS. Posterior reversible encephalopathy syndrome, part 2: Controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol 2008;29:1043-9.
  • 4 Hinchey J, Chaves C, Appignani B, Breen J, Pao L, Wang A, et al. A reversible posterior leukoencephalopathy syndrome. N Engl J Med 1996;334:494-500.
  • 5 Dongre A, Gulia S, Arora B, Kurkure PA, Banavali SD. Posterior reversible encephalopathy syndrome (PRES) in pediatric cancer patients. PHOCON 2009/OP1 [Abstract]. Available from: http://www.phoindia.org/pdf/all-abstracts-PHOCON-2009-chandigarh.pdf [Last accessed on 2010 Dec 26].
  • 6 McKinney AM, Short J, Truwit CL, McKinney ZJ, Kozak OS, SantaCruz KS, et al. Posterior reversible encephalopathy syndrome: Incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol 2007;189:904-12.
  • 7 Fugate JE, Claassen DO, Cloft HJ, Kallmes DF, Kozak OS, Rabinstein AA. Posterior reversible encephalopathy syndrome: Associated clinical and radiologic findings. Mayo Clin Proc 2010;85:427-32.
  • 8 Prasad N, Gulati S, Gupta RK, Kumar R, Sharma K, Sharma RK. Is reversible posterior leukoencephalopathy with severe hypertension completely reversible in all patients? Pediatr Nephrol 2003;18:1161-6.