Background:The main pathological changes of reversible posterior leukoencephalopathy syndrome（RPLS） are vasogenic cerebral edema, which may be related to high blood perfusion and vascular endothelial cell damage.
Methods:This article reports a 39-year-old male patient with a history of hypertension and no other special medical history. The blood pressure was 206/146 mmHg when he was admitted to the hospital, He presented with dizziness and headache. Functional MRI and enhanced cranial magnetic resonance imaging revealed acute infarction of the right frontotemporal lobe, multiple abnormal signals in the bilateral pons, pons, midbrain, posterior limb of the internal capsule, thalamus, bilateral periventricular white matter, body of the corpus callosum, and C4 segment of the cervical cord, and lumbar puncture measured intracranial pressure of 170 mmH2o. Oligoclonal bands in blood and cerebrospinal fluid, negative AQP4 and MOG antibodies, and negative immune and infection-related tests. Treatments such as lowering blood pressure and improving circulation were given, and reexamination of cranial magnetic resonance imaging revealed that the range of the lesion was significantly smaller than before, and the abnormal signal of C4 segment of the cervical cord disappeared.
Results:The diagnosis was RPLS.
Conclusion:The purpose of reporting this case is to illustrate the clinical characteristics of RPLS and the rare situation of spinal cord involvement as well as the diagnosis and treatment methods.