Case Presentation: A 77-year-old woman with past medical history of renal cell carcinoma with known liver metastases, status post left nephrectomy who was on Tivozanib presented with acute onset speech disturbances, headache, nausea, and vomiting. Patient reported intermittent, milder headaches and confusion over the previous three weeks, coinciding with the start of Tivozanib chemotherapy. Vitals [...]