title: Presentation with recurrent intractable headache: a patient with moyamoya syndrome--case report.
abstract: This clinical case report represents an interesting manifestation of a neurovascular condition that can be easily overlooked by the practicing healthcare provider. In the United States, a Hispanic patient of non-Asian descent presented with atypical symptoms of intractable headache and nausea with no evidence of neurologic deficits. Further diagnostic work-up was performed as the patient was not responding to traditional analgesic medication administration. Ultimately, cerebral angiogram revealed vascular occlusion with collateral circulation consistent with moyamoya syndrome. Discussion of the challenges and available clinical guidance for healthcare professionals dealing with patients presenting with intractable headache are presented in this report.
authors.affiliation: Department of Hospital Medicine, Baptist Hospital of Miami.
authors.forename: Ulisses J
authors.initials: UJ
authors.lastname: Diaz
authors.forename: Alberto J
authors.initials: AJ
authors.lastname: Cabán-Martinez
authors.forename: Gabriela E
authors.initials: GE
authors.lastname: Halder
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D003097:Collateral Circulation; D004351:Drug Resistance; D005260:Female; D020773:Headache Disorders / Q000188:drug therapy / Q000209:etiology*; D006630:Hispanic or Latino; D006801:Humans; D020244:Infarction, Middle Cerebral Artery / Q000175:diagnosis / Q000209:etiology; D018810:Magnetic Resonance Angiography; D008881:Migraine Disorders / Q000209:etiology; D009072:Moyamoya Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D009325:Nausea / Q000209:etiology; D012008:Recurrence
chemical_list: D000700:Analgesics