Case 416 · ICHD-3 6.7.4
6.7.4 Headache attributed to intracranial artery dissection
- 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:
Sex/Age: Male, 48 years
History: Mild arterial hypertension, smoking (20 pack-years)
Previous history: No previous episodes of significant headache
History of Present Illness (HPI):
Main symptom: Sudden and intense headache (9/10) for 12 hours
Characteristics of the pain:
Location: Right hemicranium
Character: "Stabbing", pulsatile
Triggering factor: Occurred during intense physical activity
Associated symptoms:
Right eyelid ptosis
Diplopia
Nausea without vomiting
Physical/Neurological Examination:
Pupils: Anisocoria (right > left)
Right third cranial nerve palsy
No other focal neurological deficits
Neck: No nuchal rigidity
Complementary Exams:
Brain MR Angiography: Dissection of the right internal carotid artery in the intracavernous segment
Non-contrast cranial CT: No signs of subarachnoid hemorrhage or acute ischemia
Report this case — e.g. suspected re-identification risk.