Online Images in the Medical Sciences| Volume 364, ISSUE 3, e29-e30, September 2022

Pheochromocytoma-related posterior reversible encephalopathy syndrome

      A 65-year-old man presented to a hospital complaining of memory disturbance after a motor vehicle accident. While driving, he had had an episode of loss of consciousness accompanied by blurred vision. He had had headache and vertigo for several months. His medical history included hypertension, diabetes mellitus, and atrial fibrillation. However, he had discontinued treatment of his own accord a few years previously. Computed tomography showed intracranial and left adrenal lesions. He was therefore referred to our hospital for diagnosis. The patient described symptoms of headache, palpitations, and lightheadedness and had a tremor. His blood pressure on admission was 175/80 mmHg and fluctuated markedly thereafter. Contrast-enhanced computed tomography of the abdomen revealed a 6-cm necrotizing left adrenal neoplasm. Axial fluid-attenuated inversion recovery magnetic resonance imaging showed hyperintensity in both posterior parietal lobes with intracranial hemorrhage within larger regions of vasogenic edema on the left (Figure A).
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