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Transient stabbing headache from an acute thalamic hemorrhage.

Robbins MS - J Headache Pain (2011)

Bottom Line: Stabbing headache can be encountered in both primary and secondary forms, but has been infrequently reported among patients with stroke, and is not known to be associated with a small well-circumscribed brain lesion.Neuroimaging revealed a small left thalamic hematoma.This association of an acute thalamic lesion with stabbing headache in the contralateral trigeminal distribution is discussed, along with a brief review of stabbing headache occurring in cerebrovascular disease.

View Article: PubMed Central - PubMed

Affiliation: Montefiore Headache Center, The Saul R. Korey . marobbin@montefiore.org

ABSTRACT
Stabbing headache can be encountered in both primary and secondary forms, but has been infrequently reported among patients with stroke, and is not known to be associated with a small well-circumscribed brain lesion. A 95-year-old woman taking warfarin presented with the sudden onset of stabbing headache strictly in the right frontal and supraorbital regions, along with gait imbalance and dysarthria. Neuroimaging revealed a small left thalamic hematoma. This association of an acute thalamic lesion with stabbing headache in the contralateral trigeminal distribution is discussed, along with a brief review of stabbing headache occurring in cerebrovascular disease.

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Related in: MedlinePlus

Axial noncontrast computed tomography of the brain revealed an acute, rounded hyperdense lesion in the region of the left thalamus and likely abutting the posterior limb of the internal capsule (white arrow), corresponding to a small acute hemorrhage
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Fig1: Axial noncontrast computed tomography of the brain revealed an acute, rounded hyperdense lesion in the region of the left thalamus and likely abutting the posterior limb of the internal capsule (white arrow), corresponding to a small acute hemorrhage

Mentions: Laboratory data revealed normal serum chemistry, hematocrit, and platelets. She had a white blood cell count of 12,000/μl, a total bilirubin of 2.3 mg/dL, a direct bilirubin of 1.2 mg/dL, an alkaline phosphatase of 560 U/L, a SGOT of 341 U/L, and a SGPT of 292 U/L. Her international normalized ratio was 3.2. An electrocardiogram revealed normal sinus rhythm. Noncontrast computed tomography of the head revealed a rounded hyperdense lesion in the left lateral thalamus abutting the posterior limb of the internal capsule, consistent with an acute small hemorrhage, along with multiple subcortical lacunes and white matter ischemic changes (Fig. 1). The hematoma volume was estimated to be 0.12 cm3 using the ABC/2 method [10].Fig. 1


Transient stabbing headache from an acute thalamic hemorrhage.

Robbins MS - J Headache Pain (2011)

Axial noncontrast computed tomography of the brain revealed an acute, rounded hyperdense lesion in the region of the left thalamus and likely abutting the posterior limb of the internal capsule (white arrow), corresponding to a small acute hemorrhage
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3094649&req=5

Fig1: Axial noncontrast computed tomography of the brain revealed an acute, rounded hyperdense lesion in the region of the left thalamus and likely abutting the posterior limb of the internal capsule (white arrow), corresponding to a small acute hemorrhage
Mentions: Laboratory data revealed normal serum chemistry, hematocrit, and platelets. She had a white blood cell count of 12,000/μl, a total bilirubin of 2.3 mg/dL, a direct bilirubin of 1.2 mg/dL, an alkaline phosphatase of 560 U/L, a SGOT of 341 U/L, and a SGPT of 292 U/L. Her international normalized ratio was 3.2. An electrocardiogram revealed normal sinus rhythm. Noncontrast computed tomography of the head revealed a rounded hyperdense lesion in the left lateral thalamus abutting the posterior limb of the internal capsule, consistent with an acute small hemorrhage, along with multiple subcortical lacunes and white matter ischemic changes (Fig. 1). The hematoma volume was estimated to be 0.12 cm3 using the ABC/2 method [10].Fig. 1

Bottom Line: Stabbing headache can be encountered in both primary and secondary forms, but has been infrequently reported among patients with stroke, and is not known to be associated with a small well-circumscribed brain lesion.Neuroimaging revealed a small left thalamic hematoma.This association of an acute thalamic lesion with stabbing headache in the contralateral trigeminal distribution is discussed, along with a brief review of stabbing headache occurring in cerebrovascular disease.

View Article: PubMed Central - PubMed

Affiliation: Montefiore Headache Center, The Saul R. Korey . marobbin@montefiore.org

ABSTRACT
Stabbing headache can be encountered in both primary and secondary forms, but has been infrequently reported among patients with stroke, and is not known to be associated with a small well-circumscribed brain lesion. A 95-year-old woman taking warfarin presented with the sudden onset of stabbing headache strictly in the right frontal and supraorbital regions, along with gait imbalance and dysarthria. Neuroimaging revealed a small left thalamic hematoma. This association of an acute thalamic lesion with stabbing headache in the contralateral trigeminal distribution is discussed, along with a brief review of stabbing headache occurring in cerebrovascular disease.

Show MeSH
Related in: MedlinePlus