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.