Cefalea thunderclap
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![CEFALEA THUNDERCLAP ,[object Object],[object Object]](data:image/gif;base64,R0lGODlhAQABAIAAAAAAAP///yH5BAEAAAAALAAAAAABAAEAAAIBRAA7)
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Cefalea thunderclap
- 1. MIGUEL ANGEL LUCERO MADUEÑA NEUROLOGIA CEFALEA THUNDERCLAP
Notes de l'éditeur
- Masculino de 23 años de edad, con 5 episodios de dolor severo, con TAC,RM y LCR normales. 5 dias despues se realizo una angiografia convencional encontrando vasoconstriccion en ACM y ACA de tipo multifocal difuso, pueded ser precipida por ejercicio, maniobra de valsalva, actividad sexual, HAS, drogas simpaticomimeticas
- Hombre de 69 años, sin cefaleas previas, desarrolla cefalea intensa de hemicraneo derecho, asociado a nausea y vomitos, TAC normal, se repitio a los 6 dias se encontro hemorragia lobulo temporal derecho RM confirmo hallazgo y se hizo angiografia de 4 vasos sin fase venosa normal, se realizo fase venosa y se encontro TVC del seno sigmoides y transverso
- Figure 1. Angiographic studies of patient 1. A, Selective angiography of the right common carotid artery (lateral view) showing a flamelike RICA occlusion indicative of a dissection. B, Capillary-phase angiographic view (parenchymography) after injection through the LICA revealed a large right frontoparietal hypoperfused area. C, After stenting, arterial caliber was restored with fully normalized flow through the RICA. D, Poststenting parenchymography (injection through the repaired RICA) shows no perfusion defect.
- Figure. Case 2. (A) Gadolinium-enhanced MR angiography (Gd-MRA) and cervical axial MRI sections show a dissection of the right carotid artery (stenotic form) and no lesion on the contralateral artery. (B) Gd-MRA and cervical axial MRI performed 53 days later show improvement of the right carotid dissection and an asymptomatic aneurysmal left carotid artery dissection.
- Figure. (A) CT without contrast reveals a distortion of the usual pentagonal shape (arrow) of the suprasellar cistern by an isodense pituitary tumor. (B) T1-weighted MRI shows a large pituitary mass with hyperintensities at the border, indicating acute hemorrhage.
- Un paciente con encefalopatia hipertensiva severa muestra anormalidades en terrritorio de ACP y zonas limitrofes. A T1W1 B,C FLAIR y T1 poscontraste. Notese el realce en parche