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Thunderclap headache as initial manifestation of Vogt-Koyanagi-Harada disease
Jun Hyung Cho1, Jung Yong Ahn, Suk Ho Byeon
1Brain Research Institute, Yonsei University College of Medicine--Department of Neurosurgery, Seoul, Korea.
Abstract:
A 59-year-old Asian woman suffered from a TCH followed by sudden, binocular blurred vision, mimicking pituitary apoplexy. The diagnostic workup (including fluorescein angiography, MRI of the brain, and CSF analysis) showed severe optic disc swelling and dye leakage of multiple faint hyperfluorescent spots at retinal pigment epithelium level, diffuse pachymeningeal hypertrophy, and monocytic pleocytosis, respectively. VKH disease should be considered in the differential diagnosis of patients presenting with a TCH followed by sudden, bilateral decreased visual acuity.
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