Is LP indicated for patients with recurrent thunderclap headaches over a 4-week period and negative head imaging for SAH?

Topics: Neurology • Vascular Neurology • General Neurology

Answer from: at Community Practice

I think this depends on what kind of head imaging was done to rule out SAH. If the patient has had a totally normal head MRI and MRA (not only ruling out SAH, aneurysm but also RCVS), then LP is warranted to insure there is no inflammatory or infectious component as a cause for the headache. I think...

Comments

at Shaare Zedek Medical Center
Recurrent TCH (assuming correctly diagnosed as Dr....

at University of Nebraska Medical Center
Vascular imaging was done to rule out aneurysm and...

at Novant Health
If you are ruling out SAH, MRI with GRE would mayb...

Answer from: at Community Practice

Such benign presentation (recurrent thunderclap headaches only) may have been RCVS but the diagnosis may have been missed. Spasm peaks around 10 days after headache onset. When arterial imaging is done too early or too late, arterial spasm and specific RCVS diagnosis might be missed. CTA, MRA, and a...

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