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KMID : 0385920120230050745
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Journal of the Korean Society of Emergency Medicine
2012 Volume.23 No. 5 p.745 ~ p.749
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A Case of Right Middle Cerebral Artery Infarction Presenting as Thunderclap Headache
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Han Sang-Don
Jo Yoon-Sik
Choi Jin-Young
Kim Shin-Kyoung
Kim Jin-Young
Ahn Shin
Lim Kyoung-Soo
Lee Jae-Lyun
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Abstract
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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.
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KEYWORD
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Thunderclap headache, Cerebral infarction, Diffusion magnetic resonance imaging, Emergency medical services
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