headache.bench

Origin: Synthetic
Language: English — also available in German
Contributed by: Imported case — HeadAI synthetic vignettes (de Andrade JBC, da Silva Costa TB, Vasconcelos JL, Lopes TLM, Balsells MD, Cristofolini VL, Querobin SO, Filho FMR. Validation of an AI-based platform for structured diagnosis of headache disorders using ICHD-3 criteria. BMC Neurology 25, 489 (2025). doi:10.1186/s12883-025-04473-1. Dataset: Andrade J. Head.AI Platform. Mendeley Data, V2 (2025). doi:10.17632/4fms6cw2s5.2)

Anamnesis

Identification: Female patient, 42 years old, previously healthy, presenting with a subacute progressive headache for 3 weeks.

Current Illness History:

Diffuse headache (7/10), constant, with paroxysmal exacerbations

Characteristics:

Worsens at night

Resistant to common analgesics

Associated with:

Fluctuating mental confusion

Progressive cognitive deficit (recent memory)

Episodes of transient diplopia

Constitutional symptoms:

Weight loss (4kg in 3 weeks)

Evening fever (37.8°C)

No history of:

Recent infections

Known autoimmune diseases

Illicit drug use

Neurological Examination:

Mental state:

Disorientation in time and space

Psychomotor slowing

Focal signs:

Mild right hemiparesis (4+/5)

Asymmetric reflexes (R>L)

NIHSS: 4 (mainly due to cognitive deficit)

Complementary Exams:

Brain MRI:

Multiple areas of T2/FLAIR hyperintensity (bilateral subcortical)

Post-contrast leptomeningeal enhancement

MR Angiography: Segmental stenoses in middle cerebral arteries

Lumbar puncture:

Clear CSF, normal opening pressure

Lymphocytic pleocytosis (25 cells/mm³)

Elevated proteins (80mg/dL)

Increased IgG, positive oligoclonal bands

Leptomeningeal biopsy (gold standard):

Transmural inflammatory infiltrate

Fibrinoid necrosis of small/medium vessels

Report this case — e.g. suspected re-identification risk.