Case Presentation: A 60-year-old female with history of hypertension, rheumatoid arthritis on Adalimumab, and end stage renal disease (ESRD) due to lupus nephritis for which she was recently started on mycophenolate and high dose steroids, presented with 2-3 hour history of sudden onset severe occipital headache, followed by vomiting episodes and complete loss of vision. [...]