Neurofibromatosis type 1 first presented as hypertensive crisis.

Neurofibromatosis type 1 (NF1) is known to cause vascular complications including stenotic and aneurysmal disease. Here, we report a case of a woman in her early 20s, who presented with unilateral facial nerve palsy and hypertensive crisis, and was later found to have multiple bilateral intrarenal microaneurysms along with classic cutaneous manifestations of NF1. A causal relationship between the pathophysiology of NF1 and the development of renal artery microaneurysm and hypertension is proposed in this case report.