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J Neurol Neurosurg Psychiatry. 2008 May;79(5):602-5. Epub 2007 Dec 12.

Call-Fleming syndrome associated with subarachnoid haemorrhage: three new cases.

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  • 1University of Cambridge, Department of Clinical Neurosciences, Addenbrooke's Hospital, Cambridge CB2 2QQ, UK.

Abstract

BACKGROUND:

The Call-Fleming syndrome (CFS) comprises acute severe recurrent (thunderclap) headaches, occasional transient or fluctuating neurological abnormalities and reversible segmental cerebral vasoconstriction. It is a benign condition with an excellent prognosis, yet because it is often clinically and radiologically similar to a number of commonly encountered conditions, diagnostic difficulties may arise, leading to inappropriate, and even potentially harmful, investigative and therapeutic approaches.

CASES:

Three personal cases are presented to highlight the occurrence of subarachnoid haemorrhage (SAH) as part of CFS. In two patients with a positive CT head, SAH involved the sulci in the upper cerebral convexity, an unusual location in aneurysmal SAH.

RESULTS:

SAH is not an uncommon feature of CFS, occurring in approximately 25% of reported cases, and may pose a diagnostic challenge. CFS has a relatively characteristic spectrum of features, allowing a confident diagnosis in most cases, even when atypical features such as SAH are present.

CONCLUSIONS:

Recognising the spectrum of abnormalities seen in CFS, including particularly SAH, allows a sound approach to a safe diagnosis.

PMID:
18077478
[PubMed - indexed for MEDLINE]
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