A Case of Right Middle Cerebral Artery Infarction Presenting as Thunderclap Headache.
- Author:
Sang Don HAN
1
;
Yoon Sik JO
;
Jin Yong CHOI
;
Shin Kyoung KIM
;
Jin Yong KIM
Author Information
1. Department of Neurology, Konkuk University School of Medicine, Chungju, Korea.
- Publication Type:Case Report
- Keywords:
Thunderclap headache;
Cerebral infarction;
Diffusion magnetic resonance imaging;
Emergency medical services
- MeSH:
Arteries;
Brain;
Cerebral Infarction;
Diagnosis, Differential;
Diffusion;
Diffusion Magnetic Resonance Imaging;
Emergency Medical Services;
Headache;
Headache Disorders, Primary;
Hematoma;
Humans;
Infarction, Middle Cerebral Artery;
Intracranial Aneurysm;
Intracranial Hypotension;
Leukoencephalopathies;
Magnetic Resonance Imaging;
Neurologic Examination;
Pituitary Apoplexy;
Spinal Puncture;
Subarachnoid Hemorrhage;
Venous Thrombosis
- From:Journal of the Korean Society of Emergency Medicine
2012;23(5):745-749
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Thunderclap headache refers to a sudden and severe headache that comes unexpectedly, reminding one of a clap of thunder. The initial description of this type of headache was in association with an unruptured intracranial aneurysm. It is known to be a presenting feature of subarachnoid hemorrhage, unruptured intracranial aneurysm, cerebral venous thrombosis, cervical artery dissection, spontaneous intracranial hypotension, pituitary apoplexy, retroclival hematoma, and hypertensive reversible posterior leukoencephalopathy. A formula for diagnostic assessment of thunderclap headache, such as brain computed tomographic scan and spinal tap, should be established. We experienced a case of cerebral infarction presented with thunderclap headache, diagnosed using diffusion weighted magnetic resonance imaging. We suggest that, even when these patients have shown non-specific findings on neurological examination, brain computed tomography, and cerebrospinal fluid analysis, diffusion MRI should be considered for differential diagnosis of thunderclap headache in emergency medical services.
