Case Presentation: A 19-year-old male with history of VACTERL, end-stage kidney disease with kidney transplant 7 years prior, scoliosis with T8-L2 fusion 8 years prior, reversible posterior leukoencephalopathy syndrome (PRES), depression, and recent admission for suspected cannabinoid hyperemesis syndrome presented to the ED after a fall due to weakness, and recurrent nausea and vomiting.Physical exam [...]