We presented a case of a 47 year old male presenting for hospital follow up. 2 months prior he was admitted with a left intraparenchymal hemorrhage with IVH extension. His hemorrhage was thought to be due to hypertension and he was discharged on 3 blood pressure medications. At the visit his wife expressed concern that his BP was still elevated despite compliance with his medications. He also complained of periodic abdominal pain, diaphoresis and nausea episodes that last about 10-15 minutes before terminating spontaneously. Due to drinking history as well as smoking and HTN an abdominal CT was ordered which revealed and adrenal incidentaloma of 2.5cm, work up for functionality was negative. His BP was eventually controlled by adding a diuretic and reduction of alcohol intake.