Document Detail


Thunderclap headache: It is always sub-arachnoid hemorrhage. Is it? - A case report and Review.
MedLine Citation:
PMID:  24778910     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spontaneous intracranial hypotension (SIH) is one of the relatively misdiagnosed pathophysiological entities by virtue of its presentation. SIH is a condition involving reduced intracranial pressure usually secondary to dural tear. There is recent increase in reporting of its varied presentation in literature. Critical care physicians and neurosurgeons are recognizing it in higher numbers than before. SIH is characterized by sudden onset of orthostatic headache and may be associated with neck stiffness, nausea, vomiting, tinnitus, deafness, and cognitive abnormalities. Since its imaging characteristics resemble classic subdural hematoma from other causes wrong diagnosis and intervention might have devastating outcome.
CASE DESCRIPTION: Here we discuss a case presented to us with severe headache of sudden onset without any associated problems. Patient was initially being treated as sinusitis and later diagnosed as bilateral subdural hematoma and surgical intervention was being considered. Thorough history taking and physical examination lead to strong suspicion of intracranial hypotension (IH) and patient showed dramatic improvement with epidural blood patch.
CONCLUSION: IH is a commonly misdiagnosed entity. A high index of suspicion is required for timely diagnosis, in order to minimize unwanted therapeutic interventions that can worsen the patient's condition and to help initiate early and simple interventions.
Authors:
Raghunath Aladakatti; Laxmikant B Sannakki; Peter Y Cai; Roselle Derequito
Publication Detail:
Type:  Journal Article     Date:  2014-02-21
Journal Detail:
Title:  Surgical neurology international     Volume:  5     ISSN:  2229-5097     ISO Abbreviation:  Surg Neurol Int     Publication Date:  2014  
Date Detail:
Created Date:  2014-04-29     Completed Date:  2014-04-29     Revised Date:  2014-05-07    
Medline Journal Info:
Nlm Unique ID:  101535836     Medline TA:  Surg Neurol Int     Country:  India    
Other Details:
Languages:  eng     Pagination:  22     Citation Subset:  -    
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