Cerebrovascular Manifestations of Pheochromocytoma and the Implications of a Missed Diagnosis
Purchase on Springer.com
$39.95 / €34.95 / £29.95*
Rent the article at a discountRent now
* Final gross prices may vary according to local VAT.
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.
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.
- Ducros A, Boukobza M, Porcher R, Sarov M, Valade D, Bousser MG. The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain. 2007;130:3091–101. CrossRef
- Razavi M, Bendixen B, Maley JE, Zargarian M, Razavi B, Adams HP. CNS pseudovasculitis in a patient with pheochromocytoma. Neurology. 1999;52:1088–90.
- Levine RJ, Lam C, Qian C, Yu KF, Maynard SE, Sachs BP, et al. CPEP study group. Soluble endoglin and other circulating antiangiogenic factors in preeclampsia. N Engl J Med. 2006;355:992–1005. CrossRef
- Glusker P, Recht L, Lane B. Reversible posterior leukoencephalopathy syndrome and bevacizumab. N Engl J Med. 2006;354:980–2. CrossRef
- Eisenhofer G, Rivers G, Rosas AL, Quezado Z, Manger WM, Pacak K. Adverse drug reactions in patients with phaeochromocytoma: incidence, prevention and management. Drugs. 2007;30:1031–62.
- Raisanen J, Shapiro B, Glazer GM, Desai S, Sisson JC. Plasma catecholamines in pheochromocytoma: effect of urographic contrast media. Am J Roentgenol. 1984;143:43–6.
- Cerebrovascular Manifestations of Pheochromocytoma and the Implications of a Missed Diagnosis
Volume 9, Issue 3 , pp 378-381
- Cover Date
- Print ISSN
- Online ISSN
- Humana Press Inc
- Additional Links
- Cerebral vasospasm
- Industry Sectors
- Author Affiliations
- 1. Department of Neurology and Rehabilitation, University of Illinois at Chicago, Chicago, IL, USA
- 2. Department of Neurology and Rehabilitation, University of Illinois at Chicago, 912 S. Wood Street, 855N, NPI, MC 796, Chicago, IL, 60612, USA