Disclosures: Jennifer M. Cushman, MD: Nothing to disclose

Case Description: 38-year-old female with no significant PMH presented initially to the emergency room due to severe hypertension, nausea, gait imbalance, progressively worsening headaches, and dizziness. She recently gave birth 2 months prior. Patient initially attributed symptoms to be post-partum related. MRI showed an enhancing extra-axial mass along right petrous apex causing a mass effect on the pons, medulla and the right cerebellar hemisphere without hydrocephalus, which caused her symptoms.

Setting: Full-Service Acute Care Facility

Patient: 38-year-old female with no significant PMH presents to IRF to engage in inpatient rehabilitation to address problems with diplopia, balance, speech and swallow impairments, and management of emesis and vomiting following a craniectomy of a rare paraganglioma.

Assessment/Results: Patient presented with rare brain neoplasm that required extensive inpatient therapy due to worsening of mental status and impaired cognition throughout therapy. This case outlines the multidisciplinary approach necessary to optimize therapy and strategize the management following craniectomy.

Discussion: Paragangliomas are rare neoplasms arising from extra-adrenal chromaffin cells. The clinical patterns of paraganglioma are commonly described together with a pheochromocytoma. Neoplasms localized in the head and neck region may cause cranial nerve palsies, impinging the vagus and hypoglossal nerves causing swallowing impairment. Paraganglioma close to the Glomus tympanicum and Glomus jugulare can present as a middle ear mass resulting in tinnitus. About 85% of paragangliomas develop in the abdomen, 12% develop in the chest, and 3% in the head and neck region. Many can present with malignant hypertension, headache, and visual and balance abnormalities depending on location of tumor.

Conclusion: Many complications such as speech and swallow impairment, balance, diplopia, and impairment of breathing following resection of brain tumor may result. This case outlines the importance of a multidisciplinary team approach during rehab at an IRF and investigates various complications resulting from this rare brain neoplasm.

Level of Evidence: Level V

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PM&R Meeting Abstracts - https://pmrjabstracts.org/abstract/complicated-rehabilitation-course-of-a-patient-recovering-post-craniectomy-from-a-neurosurgical-resection-of-rare-paraganglioma-a-case-report/