Posterior Reversible Encephalopathy Syndrome and Cerebral Sinus Thrombosis in a Case of Pediatric B-Cell ALL

J Pediatr Hematol Oncol. 2017 Mar;39(2):e71-e73. doi: 10.1097/MPH.0000000000000728.


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.

Publication types

  • Case Reports

MeSH terms

  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Brain Ischemia / diagnostic imaging
  • Brain Ischemia / etiology
  • Cerebral Infarction / diagnostic imaging
  • Cerebral Infarction / etiology
  • Child, Preschool
  • Enalapril / therapeutic use
  • Enoxaparin / therapeutic use
  • Female
  • Humans
  • Intracranial Hypertension / drug therapy
  • Intracranial Hypertension / etiology
  • Magnetic Resonance Imaging
  • Neuroimaging
  • Occipital Lobe / diagnostic imaging
  • Papilledema / etiology
  • Parietal Lobe / diagnostic imaging
  • Posterior Leukoencephalopathy Syndrome / diagnostic imaging
  • Posterior Leukoencephalopathy Syndrome / etiology*
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / complications*
  • Precursor B-Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • Remission Induction
  • Sinus Thrombosis, Intracranial / diagnostic imaging
  • Sinus Thrombosis, Intracranial / etiology*


  • Enoxaparin
  • Enalapril