We read with great interest the article written by Long et al. and published in The Journal of Emergency Medicine entitled, “The Thunderclap Headache: Approach and Management in the Emergency Department” (
1). The authors provided an excellent review of the various conditions that can present clinically in association with thunderclap headaches. The authors also proposed a diagnostic algorithm for their diagnosis. However, we would like to discuss the role of high-resolution vessel wall imaging (HR-VWI), a magnetic resonance imaging (MRI) technique not mentioned by the authors, in the diagnosis of two conditions that can present with thunderclap headache. These conditions are demonstrated in a case of reversible cerebral vasoconstriction syndrome (RCVS) and in a case of vertebral artery dissection, which we will describe here.
- Long D.
- Koyfman A.
- Long B.
The thunderclap headache: approach and management in the emergency department.
J Emerg Med. 2019; 56: 633-641
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- The thunderclap headache: approach and management in the emergency department.J Emerg Med. 2019; 56: 633-641
- Intracranial vessel wall MRI: principles and expert consensus recommendations of the American Society of Neuroradiology.AJNR Am J Neuroradiol. 2017; 38: 218-229
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- Imaging investigation of intracranial arterial dissecting aneurysms by using 3 T high-resolution MRI and DSA: from the interventional neuroradiologists' view.Acta Neurochir (Wien). 2014; 156: 515-525
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- The Thunderclap Headache: Approach and Management in the Emergency DepartmentJournal of Emergency MedicineVol. 56Issue 6