Abstract
BackgroundSyndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocitosis (HaNDL) is a rare disease which can present with focal neurological deficits and mimic stroke. A neurologist-on-duty faced with a HaNDL patient in the first hours might erroneously decide to use thrombolytic drugs, a non-innocuous treatment which has no therapeutic effect on this syndrome.Case PresentationWe present a case where neuroimaging, together with the clinical picture, led to a presumed diagnosis of HaNDL avoiding intravenous thrombolysis.ConclusionsThis report shows the usefulness of multimodal MR imaging in achieving early diagnosis during an acute neurological attack of HaNDL. Our experience, along with that of others, demonstrates that neuroimaging tests reveal the presence of cerebral hypoperfusion in HaNDL syndrome
Highlights
Syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocitosis (HaNDL) is a rare disease which can present with focal neurological deficits and mimic stroke
Syndrome of transient Headache and Neurological Deficits with cerebrospinal fluid Lymphocitosis (HaNDL, ICHD-II 7.8), previously termed as pseudomigraine with lymphocytic pleocytosis, is a rare disease that was first described by Bartleson et al in 1981 [1]
The International Classification of Headache Disorders diagnostic criteria for HaNDL are: (A) episodes of moderate or severe headache lasting hours; (B) CSF pleocytosis with lymphocytic predominance and normal neuroimaging, CSF culture and other tests for aetiology; (C) episodes of headache are accompanied by transient neurological deficits; and (D) episodes of headache and neurological deficits recur over
Summary
Along with that of others, demonstrates that neuroimaging tests reveal the presence of cerebral hypoperfusion in HaNDL syndrome
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