Thunderclap headache as initial manifestation of Vogt-Koyanagi-Harada disease.
A 59-year-old Asian woman suffered from a TCH followed by sudden, binocular blurred vision, mimicking pituitary apoplexy. The diagnostic workup (including fluorescein angiography, MRI of the brain, and CSF analysis) showed severe optic disc swelling and dye leakage of multiple faint hyperfluorescent spots at retinal pigment epithelium level, diffuse pachymeningeal hypertrophy, and monocytic pleocytosis, respectively. VKH disease should be considered in the differential diagnosis of patients presenting with a TCH followed by sudden, bilateral decreased visual acuity.
Cho
Jun Hyung
JH
Brain Research Institute, Yonsei University College of Medicine--Department of Neurosurgery, Seoul, Korea.
Ahn
Jung Yong
JY
Byeon
Suk Ho
SH
Huh
Ji Soon
JS
D001921:Brain / Q000473:pathology; D005260:Female; D005451:Fluorescein Angiography; D051270:Headache Disorders, Primary / Q000150:complications* / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D014607:Uveomeningoencephalitic Syndrome / Q000175:diagnosis* / Q000209:etiology*