Case of the Month: August, 2011

Submitted by Michael Witkosky, MD.

History:

18 year old male with end stage renal disease secondary to focal segmental glomerulosclerosis, status post renal transplant in 2009. The patient’s renal transplant was unsuccessful and is currently on hemodialysis. The patient presents to the emergency room with headache, blurry vision, and blood pressure of 155/110. Physical exam is within normal limits. Glucose = 96. BUN  and creatinine are normal (the patient recently underwent hemodialysis)

CT Brain without intravenous contrast:

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Question:

Given the radiographic presentation, differential diagnosis includes which of the following?

  1. Posterior reversible encephalopathy syndrome
  2. Acute ischemia-infarction
  3. Hypoglycemia
  4. Gliomatosis cerebri
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