{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,17]],"date-time":"2026-07-17T00:28:42Z","timestamp":1784248122110,"version":"3.55.0"},"reference-count":10,"publisher":"The Endocrine Society","issue":"1","license":[{"start":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T00:00:00Z","timestamp":1668556800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,11,17]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Pheochromocytomas are rare adrenal tumors that are often diagnosed in workup for endocrine causes of refractory hypertension, as an incidental imaging finding, or in patients with classic symptoms of headache, palpitations, and\/or diaphoresis. We describe a case of pheochromocytoma presenting in a 63-year-old woman with spontaneous and multifocal subarachnoid and intracerebral hemorrhage without underlying vasculopathy. The patient previously had no documented episodes of hypertension and took no regular medications. She experienced sudden-onset severe headache and presented with hypertensive crisis. Cranial imaging showed bifrontal and right temporal convexal subarachnoid and intracerebral hemorrhage of unknown etiology. Cranial arterial catheterization showed no vascular malformation underlying the site of hemorrhage. Given concern for potential malignant etiology, cross-sectional body imaging was performed that revealed a 7-cm right adrenal heterogeneous mass. Biochemical workup demonstrated markedly elevated plasma metanephrine and normetanephrine levels, diagnostic of pheochromocytoma. She underwent \u03b1- and \u03b2-blockade, and evaluation with a multidisciplinary team including repeat intracranial imaging to ensure resolution of the intracranial bleeding before definitive surgical management. She then underwent successful laparoscopic adrenalectomy. This case demonstrates that the workup of cryptogenic intracranial hemorrhage and hypertensive crisis should include evaluation for catecholamine-secreting tumors.<\/jats:p>","DOI":"10.1210\/jendso\/bvac176","type":"journal-article","created":{"date-parts":[[2022,11,16]],"date-time":"2022-11-16T17:28:54Z","timestamp":1668619734000},"source":"Crossref","is-referenced-by-count":7,"title":["Pheochromocytoma-induced Subarachnoid and Intracerebral Hemorrhage"],"prefix":"10.1210","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0727-4365","authenticated-orcid":false,"given":"Lauren L","family":"Agoubi","sequence":"first","affiliation":[{"name":"Department of Surgery, Division of General Surgery, University of Washington, Seattle, Washington 98195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9044-2221","authenticated-orcid":false,"given":"Sandeep P","family":"Khot","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Washington , Seattle, Washington 98195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R Alan","family":"Failor","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Division of Metabolism, Endocrinology, and Nutrition, University of Washington , Seattle, Washington 98195 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9550-7394","authenticated-orcid":false,"given":"Nicole K","family":"Zern","sequence":"additional","affiliation":[{"name":"General & Surgical Specialists, University of Washington Valley Medical Center , Renton, Washington 98055 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"80","published-online":{"date-parts":[[2022,11,16]]},"reference":[{"issue":"12","key":"2022113011101223800_bvac176-B1","doi-asserted-by":"crossref","first-page":"2331","DOI":"10.1097\/01.hjh.0000251887.01885.54","article-title":"Pheochromocytoma: presentation, diagnosis and treatment","volume":"24","author":"Reisch","year":"2006","journal-title":"J Hypertens"},{"issue":"1","key":"2022113011101223800_bvac176-B2","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1186\/s10194-021-01225-7","article-title":"Reversible cerebral vasoconstriction syndrome (RCVS): an interesting case report","volume":"22","author":"Togha","year":"2021","journal-title":"J Headache Pain"},{"issue":"3","key":"2022113011101223800_bvac176-B3","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1530\/ERC-13-0494","article-title":"Pathological grading for predicting metastasis in phaeochromocytoma and paraganglioma","volume":"21","author":"Kimura","year":"2014","journal-title":"Endocr Relat Cancer"},{"issue":"13","key":"2022113011101223800_bvac176-B4","doi-asserted-by":"crossref","first-page":"1311","DOI":"10.1056\/NEJMoa071407","article-title":"Evidence of MEN-2 in the original description of classic pheochromocytoma","volume":"357","author":"Neumann","year":"2007","journal-title":"N Engl J Med"},{"issue":"4","key":"2022113011101223800_bvac176-B5","doi-asserted-by":"crossref","first-page":"458","DOI":"10.1016\/0002-9610(60)90141-0","article-title":"Pheochromocytoma in the adult and in the child","volume":"99","author":"Hume","year":"1960","journal-title":"Am J Surg"},{"issue":"5","key":"2022113011101223800_bvac176-B6","doi-asserted-by":"crossref","first-page":"558","DOI":"10.1186\/s13054-014-0558-1","article-title":"Subarachnoid hemorrhage induces an early and reversible cardiac injury associated with catecholamine release: one-week follow-up study","volume":"18","author":"Salem","year":"2014","journal-title":"Crit Care"},{"issue":"4","key":"2022113011101223800_bvac176-B7","doi-asserted-by":"crossref","first-page":"751","DOI":"10.1016\/j.ecl.2019.08.004","article-title":"Pseudopheochromocytoma","volume":"48","author":"Mamilla","year":"2019","journal-title":"Endocrinol Metab Clin North Am"},{"issue":"3","key":"2022113011101223800_bvac176-B8","doi-asserted-by":"crossref","first-page":"298","DOI":"10.5603\/EP.a2018.0075","article-title":"Intracerebral hemorrhage as a first sign of pheochromocytoma: case report and review of the literature","volume":"70","author":"Pekic","year":"2019","journal-title":"Endokrynol Pol"},{"issue":"5","key":"2022113011101223800_bvac176-B9","doi-asserted-by":"crossref","first-page":"648","DOI":"10.1002\/ana.21951","article-title":"Magnetic resonance angiography in reversible cerebral vasoconstriction syndromes","volume":"67","author":"Chen","year":"2010","journal-title":"Ann 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