Transient hemiparesis--a cautionary tale: coexistence of phaeochromocytoma and intracranial aneurysm.

Jha, Anil; Lye, R. H.

doi:10.1136/jnnp.48.2.188

Cited by 3 publications

(3 citation statements)

References 12 publications

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“…In the report of Lo et al [2], it was diagnosed in 4 of 8,486 (0.05%) autopsies in patients with hypertension and accounted for 3 of the 4 sudden deaths in this series. Although there are reports concerning pheochromocytoma as the etiology of cerebral hemorrhage in a pregnant woman [3], pontine hemorrhage in a young man [4], cerebral aneurysms [5, 6, 7, 8, 9], cerebral infarction and disseminated intravascular coagulation in an adult [10], there are no previous reports of such tumors as the cause of spontaneous ICH in children.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Intracranial Hemorrhage Caused by Pheochromocytoma in a Child

Chuang

Hsu²,

Lin³

et al. 2002

Pediatr Neurosurg

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We report a 6-year-old boy who presented with left occipital spontaneous lobar hematoma and hypertension. Cerebral angiography failed to demonstrate a vascular malformation. Subsequently, a left adrenal tumor was found that proved to be a pheochromocytoma. This is the first report in the literature of a lobar hematoma in a child caused by a concomitant pheochromocytoma. In children with hypertension and resulting intracerebral hematoma, a pheochromocytoma should be considered in the differential diagnosis.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Intracranial Hemorrhage Caused by Pheochromocytoma in a Child

Chuang

Hsu²,

Lin³

et al. 2002

Pediatr Neurosurg

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“…A catecholamine-producing tumor with a cerebral aneurysm requires much more cautious management, but there is no definite consensus over management because of limited reports. A search of PubMed found no previous reports of GNB with a cerebral aneurysm, although there have been five reported cases of pheochromocytoma with cerebral aneurysms [ 17 – 21 ]. In four of these cases, treatment of the tumor preceded the treatment of the cerebral aneurysm [ 17 – 20 ], even though in all four cases, the risk of rupture was very high or there was a history of rupture.…”

Section: Case Presentationmentioning

confidence: 99%

“…One of these four cases developed cerebral infarction during the cerebral aneurysm surgery. In the fifth case, treatment for the pheochromocytoma proceeded because of the low risk of rupture [ 21 ]. In all of these cases, the focus during surgery was only on fluctuations in blood pressure.…”

Section: Case Presentationmentioning

confidence: 99%

Surgical strategy for an adult patient with a catecholamine-producing ganglioneuroblastoma and a cerebral aneurysm: a case report

et al. 2018

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BackgroundGanglioneuroblastomas, particularly those that produce catecholamine, are extremely rare in adults. Here, we report an interesting surgical case of an adult patient with a catecholamine-producing ganglioneuroblastomas in her adrenal gland, suspected to be a pheochromocytoma, and with a cerebral aneurysm.Case presentationThe patient was a 73-year-old woman under treatment for hypertension. During a health check-up, a cystic retroperitoneal tumor was incidentally found in the superior pole of her right kidney. Her blood adrenaline level was slightly elevated, and her urinary adrenaline, noradrenaline, and dopamine levels were above the upper reference limits. In addition, 24-h urinary excretion of metanephrine, normetanephrine, and vanillylmandelic acid were all increased. 123I-Meta-iodobenzylguanidine scintigraphy showed an abnormal accumulation of the marker in the cyst wall. She was, therefore, diagnosed with a pheochromocytoma and scheduled for tumor resection. However, preoperatively, 8-mm-diameter cerebral aneurysm was incidentally found in her basilar artery. This required careful preoperative discussion. The aneurysm was difficult to approach and treat, and based on its position, shape, and size, the risk of rupture was low. Because hypertension is a major risk factor for aneurysmal rupture, we decided to proceed with the tumor resection. A lumbar catheter was placed to monitor the cerebral aneurysm for intraoperative rupture, and her transcranial motor-evoked potential and somatosensory-evoked potentials were monitored to track her intraoperative neurological function. During surgery, we carefully monitored fluctuations in blood pressure and resected the tumor with minimal mobilization. Postoperatively, head computed tomography confirmed that there was no sign of rupture. Histopathologically, the tumor was diagnosed as a catecholamine-producing ganglioneuroblastoma. The postoperative course was good, and the patient’s blood pressure improved.ConclusionsCareful perioperative management is needed for a patient with both a catecholamine-producing tumor and cerebral aneurysm.

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