Usefulness of multimodal MR imaging in the differential diagnosis of HaNDL and acute ischemic stroke.
BACKGROUND
Syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocytosis (HaNDL) is a rare disease which can present with focal neurological deficits and mimic stroke. A neurologist-on-duty faced with a HaNDL patient in the first hours might erroneously decide to use thrombolytic drugs, a non-innocuous treatment which has no therapeutic effect on this syndrome.


METHODS
We present a case where neuroimaging, together with the clinical picture, led to a presumed diagnosis of HaNDL avoiding intravenous thrombolysis.


CONCLUSIONS
This report shows the usefulness of multimodal MR imaging in achieving early diagnosis during an acute neurological attack of HaNDL. Our experience, along with that of others, demonstrates that neuroimaging tests reveal the presence of cerebral hypoperfusion in HaNDL syndrome.
Department of Neurology, Hospital Universitario de Albacete, C/ Hermanos Falcó, Albacete 02006, Spain. tsmtsm08@yahoo.es
Tomas
T
Segura
Francisco
F
Hernandez-Fernandez
Pedro
P
Sanchez-Ayaso
Elena
E
Lozano
Lorenzo
L
Abad
D000328:Adult; D002545:Brain Ischemia / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006261:Headache / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D006801:Humans; D008218:Lymphocytosis / Q000134:cerebrospinal fluid / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D020521:Stroke / Q000175:diagnosis*