Cerebrovascular manifestations of pheochromocytoma and the implications of a missed diagnosis

Tamara Majic, Venkatesh Aiyagari

12 Scopus citations

Abstract

Background and Purpose: Cerebrovascular complications are a rare manifestation of pheochromocytoma. We report a case of pheochromocytoma presenting initially with reversible posterior leukoencephalopathy and subsequently a cerebral infarction. Summary of Case: A patient with a prior history of episodic hypertension and reversible posterior leukoencephalopathy presented with headache, palpitations, and weakness of the right leg. A magnetic resonance angiogram revealed narrowing of the basilar and right middle cerebral artery. She was diagnosed as having presumed vasculitis and underwent a conventional cerebral angiogram during which she developed a hypertensive crisis and worsening neurological deficit. Further investigations revealed the presence of a pheochromocytoma, which was subsequently resected. Conclusions: It is important to be cognizant of the possibility of pheochromocytoma in patients presenting with hypertension and cerebrovascular manifestations, as commonly used investigations (e.g. catheter angiography) and treatment modalities (e.g. β-blockers to treat hypertension, corticosteroids to treat suspected vasculitis, etc.) can lead to life threatening complications.

Original languageEnglish (US)
Pages (from-to)378-381
Number of pages4
JournalNeurocritical Care
Volume9
Issue number3
DOIs
Publication statusPublished - Dec 2008

    Fingerprint

Keywords

  • Cerebral vasospasm
  • Hypertension
  • Pheochromocytoma
  • Stroke

ASJC Scopus subject areas

  • Clinical Neurology
  • Critical Care and Intensive Care Medicine

Cite this