title: An uncommon cause of intracerebral hemorrhage in a healthy truck driver.
abstract: OBJECTIVE
  To describe a case and review literature for intracerebral hemorrhage caused by migraine.
  
  
  METHODS
  Case report.
  
  
  METHODS
  Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts.
  
  
  METHODS
  A 54-year-old truck driver with a 2-year history of atypical headaches.
  
  
  RESULTS
  A 54-year-old right-handed truck driver was seen in consultation with a 2-year history of atypical headaches.The headaches were dull, throbbing, gradually progressive,and limited over the left occipital area. They were accompanied by right visual field deficit, diplopia, and,at times, confusion. These headaches were notably different from the usual migraine headaches he had been having for more than 20 years. Brain imaging revealed left parieto-occipital lobar hemorrhage. Further investigations ruled out arteriovenous malformations. He did not have any vascular risk factors, including hypertension. Migraine-associated intracerebral hemorrhage was considered to be the most likely diagnosis.
  
  
  CONCLUSIONS
  Intracerebral hemorrhage associated with migraine is believed to result from vasoconstriction leading to ischemia of the walls of blood vessels, making them leaky and porous. It is important to be aware of this phenomenon because vasoactive medications used to treat migraine can further aggravate the vasoconstriction and hence the intracerebral bleed.
authors.affiliation: Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts 02215, USA. sankalpsgokhale@gmail.com
authors.forename: Sankalp
authors.initials: S
authors.lastname: Gokhale
authors.forename: Shivani
authors.initials: S
authors.lastname: Ghoshal
authors.forename: Sourabh
authors.initials: S
authors.lastname: Lahoti
authors.forename: Louis R
authors.initials: LR
authors.lastname: Caplan
authors.forename: Louis R
authors.initials: LR
authors.lastname: Caplan
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002543:Cerebral Hemorrhage / Q000150:complications / Q000209:etiology*; D005500:Follow-Up Studies; D006261:Headache / Q000209:etiology; D006801:Humans; D007511:Ischemia / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D008881:Migraine Disorders / Q000150:complications; D018986:Motor Vehicles; D014057:Tomography, X-Ray Computed