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Case Records of the Massachusetts General Hospital
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Volume 352:2223-2231 May 26, 2005 Number 21
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Case 16-2005 — A Nine-Year-Old Girl with Headaches and Hypertension
Daniel S. Kohane, M.D., Ph.D., Julie R. Ingelfinger, M.D., Katherine Nimkin, M.D., and Chin-Lee Wu, M.D., Ph.D.

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Presentation of Case

A nine-year-old girl was admitted to this hospital because of headaches, enuresis, recent visual changes, and vomiting.

Intermittent frontal headaches began 18 months before admission, occurring most often during physical activity, but occasionally in the early morning, accompanied by nausea, but without vomiting, visual changes, or facial flushing. The child had been squinting, and she said she had been having difficulty reading; one month before admission, the results of an eye examination were reportedly normal.

Nocturnal enuresis began eight months before admission and did not respond to fluid restriction and voiding before bedtime. The patient was evaluated by an urologist . . . [Full Text of this Article]

Differential Diagnosis

Management of Hypertensive Emergencies

            Identifying the Problem

            Treating the Problem

Perioperative Management of Pheochromocytoma

Clinical Diagnosis

Pathological Discussion

Anatomical Diagnosis


Source Information

From the Departments of Pediatric Critical Care (D.S.K.), Pediatric Nephrology (J.R.I.), Radiology (K.N.), and Pathology (C.-L.W.), Massachusetts General Hospital; and the Departments of Pediatrics (D.S.K., J.R.I.), Radiology (K.N.), and Pathology (C.-L.W.), Harvard Medical School.



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