Spontaneous intracerebral hemorrhage is very rare in patients with neurofibromatosis type 1. A 30-year-old woman was referred to our hospital for evaluation of headaches, nausea, and vomiting. She was diagnosed with neurofibromatosis type 1 and a spontaneous intracerebral hemorrhage. She was treated with conservative management, including antihypertensive medications for 32 months. However, because of sustained hypertension, we performed screening tests for a pheochromocytoma. The 24 hr urine VMA and urine metanephrines were elevated. Abdominal CT showed a right adrenal mass, 7.5 x 5.8 cm in size.. After a successful resection of the tumor, the hypertension resolved without medication for > 1 year. This case illustrates that delayed diagnosis and treatment of pheochromocytoma can cause serious complications from hypertension, such as cerebrovascular hemorrhage. Thus, in patients with neurofibromatosis and hypertension, screening for pheochromocytoma is important for the early detection of an adrenal tumor.
Adult ; Cerebral Hemorrhage ; Delayed Diagnosis ; Female ; Headache ; Hemorrhage ; Humans ; Hypertension ; Mass Screening ; Nausea ; Neurofibromatoses ; Neurofibromatosis 1 ; Pheochromocytoma ; Vomiting