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KMID : 0911820160170020060
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Korean Journal of Headache
2016 Volume.17 No. 2 p.60 ~ p.64
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Two Cases of Spontaneous Anterior Cerebral Artery Dissection Presenting with Thunderclap Headache and Transient Monoparesis
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Jeong Eun-Hye
Jung Young-Ik
Jang Hyun-Soon
Roh Sook-Young
Kim Jeong-Yeon
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Abstract
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Thunderclap headache is a severe headache of abrupt onset, rapidly reaching its maximum intensity. Thunderclap headache is frequently associated with serious disorders such as subarachnoid hemorrhage, which should be ruled out by prompt evaluation. Among secondary etiologies, there are cervicocephalic artery dissections, in which spontaneous intracranial artery dissections were considered to be rare than extracranial artery dissections, and were found much more in the vertebrobasilar system. Moreover, among dissections of the intracranial anterior circulation, anterior cerebral artery (ACA) has been less likely to be involved than other intracranial vessels. Here, we report two cases of spontaneous ACA dissection presenting with thunderclap headache and transient contralateral leg weakness, while one patient resulted in ACA territory infarction, and the other resulted in recurrent transient ischemic attack (TIA). Clinicians should consider the possibility of ACA dissection, if encountered with ACA territory infarction or TIA particularly in patients with sudden onset, severe headache as a presenting symptom.
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KEYWORD
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Thunderclap headache, Dissection, Anterior cerebral artery, Intracranial, Extracranial, Infarction, Transient ischemic attack
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