title: Thunderclap-like headache triggered by micturition and angina as an initial manifestation of bladder pheochromocytoma. A case report.
abstract: BACKGROUND
  Pheochromocytoma is a catecholamine-producing tumor characterized by hypertension, headache, tachycardia, excessive diaphoresis and angina. The thunderclap headache is so named because the pain strikes suddenly and severely. Although the symptoms of bladder pheochromocytoma are rather evident, the diagnosis of this rare neuroendocrine tumor can be missed.
  
  
  METHODS
  This study reports the case of a woman diagnosed with bladder pheochromocytoma who experienced thunderclap headache triggered by micturition and angina as an initial manifestation.
  
  
  CONCLUSIONS
  This case study suggests that thunderclap headache and angina occurring concurrently with sudden blood pressure elevation during or immediately after micturition are important diagnostic clues for bladder pheochromocytoma.
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: You Jin
authors.initials: YJ
authors.lastname: Han
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: So Young
authors.initials: SY
authors.lastname: Ock
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Eun Jung
authors.initials: EJ
authors.lastname: Kim
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Ho Sik
authors.initials: HS
authors.lastname: Shin
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Yeon Soon
authors.initials: YS
authors.lastname: Jung
authors.affiliation: Department of Internal Medicine, Kosin University College of Medicine, Busan, Korea.
authors.forename: Hark
authors.initials: H
authors.lastname: Rim
mesh_terms: D000787:Angina Pectoris / Q000209:etiology*; D001794:Blood Pressure; D015653:Cystectomy / Q000379:methods; D005260:Female; D051270:Headache Disorders, Primary / Q000209:etiology*; D006801:Humans; D007150:Immunohistochemistry; D008875:Middle Aged; D010673:Pheochromocytoma / Q000150:complications* / Q000175:diagnosis; D015898:Tomography Scanners, X-Ray Computed; D015899:Tomography, Emission-Computed, Single-Photon; D001749:Urinary Bladder Neoplasms / Q000150:complications* / Q000175:diagnosis; D014554:Urination