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<br /> ON THE CASE<br /> <br /> <br /> <br /> NOT YOUR TYPICAL<br /> MIGRAINE HEADACHE<br /> By Rahul V. Pawar, MD<br /> History and Course of Illness<br /> A 58-year-old woman with a long-standing history of<br /> migraines presented to the emergency department (ED) with<br /> an intractable migraine headache. She reported an incidence<br /> of at least one severe headache per month; however, in the<br /> preceding few weeks, they had become more frequent. In the<br /> ED, she was given a combination of valproate, ondansetron,<br /> and IV hydromorphone and dexamethasone. Occasionally, she<br /> experienced numbness and tingling involving the right side of<br /> her face and right upper extremity. One of her most severe<br /> migraine attacks culminated with a brief episode of aphasia.<br /> Although she denied having any “strokes” in t<a title="March 2011 - Radiology Today page 1" href="http://viewer.zmags.com/publication/0f67ab68?page=1">THE MAGAZINE OF DISTINCTION IN RADIOLOGYVOL. 12</a> THE MAGAZINE OF DISTINCTION IN RADIOLOGYVOL. 12<a title="March 2011 - Radiology Today page 2" href="http://viewer.zmags.com/publication/0f67ab68?page=2"> Introducing the CXDI-70C Wire</a> Introducing the CXDI-70C Wire<a title="March 2011 - Radiology Today page 3" href="http://viewer.zmags.com/publication/0f67ab68?page=3"></a> <a title="March 2011 - Radiology Today page 4" href="http://viewer.zmags.com/publication/0f67ab68?page=4">EDITOR’S NOTEA BUSY TIMEFOR SIR AND IRBy Ji</a> EDITOR’S NOTEA BUSY TIMEFOR SIR AND IRBy Ji<a title="March 2011 - Radiology Today page 5" href="http://viewer.zmags.com/publication/0f67ab68?page=5">Full Page Ad</a> Full Page Ad<a title="March 2011 - Radiology Today page 6" href="http://viewer.zmags.com/publication/0f67ab68?page=6">CONTENTS MARCH 201128features12</a> CONTENTS MARCH 201128features12<a title="March 2011 - Radiology Today page 7" href="http://viewer.zmags.com/publication/0f67ab68?page=7">For HCC patients with orwithout partial or branc</a> For HCC patients with orwithout partial or branc<a title="March 2011 - Radiology Today page 8" href="http://viewer.zmags.com/publication/0f67ab68?page=8">IMAGING INFORMATICSDEFININ</a> IMAGING INFORMATICSDEFININ<a title="March 2011 - Radiology Today page 9" href="http://viewer.zmags.com/publication/0f67ab68?page=9">USECONOMICINDICATORSCOACTIV2010SALES</a> USECONOMICINDICATORSCOACTIV2010SALES<a title="March 2011 - Radiology Today page 10" href="http://viewer.zmags.com/publication/0f67ab68?page=10">IMAGING INFORMATICSimprovements in technolog</a> IMAGING INFORMATICSimprovements in technolog<a title="March 2011 - Radiology Today page 11" href="http://viewer.zmags.com/publication/0f67ab68?page=11">SIR BOOTH 740TogeTherenhancing ThePracTic</a> SIR BOOTH 740TogeTherenhancing ThePracTic<a title="March 2011 - Radiology Today page 12" href="http://viewer.zmags.com/publication/0f67ab68?page=12">VENDORARCHIVESeparating Archiving From Other P</a> VENDORARCHIVESeparating Archiving From Other P<a title="March 2011 - Radiology Today page 13" href="http://viewer.zmags.com/publication/0f67ab68?page=13">ARCHIVEVENDORFrom Storage to Management H</a> ARCHIVEVENDORFrom Storage to Management H<a title="March 2011 - Radiology Today page 14" href="http://viewer.zmags.com/publication/0f67ab68?page=14"> “How much of this data actually adds busin</a> “How much of this data actually adds busin<a title="March 2011 - Radiology Today page 15" href="http://viewer.zmags.com/publication/0f67ab68?page=15">Healthcare organized by patient. Brilliant. </a> Healthcare organized by patient. Brilliant. <a title="March 2011 - Radiology Today page 16" href="http://viewer.zmags.com/publication/0f67ab68?page=16">are responding to customer inquiries and preparin</a> are responding to customer inquiries and preparin<a title="March 2011 - Radiology Today page 17" href="http://viewer.zmags.com/publication/0f67ab68?page=17">✶2011 Annual MeetingSan Antonio, TXJune 4-8, </a> ✶2011 Annual MeetingSan Antonio, TXJune 4-8, <a title="March 2011 - Radiology Today page 18" href="http://viewer.zmags.com/publication/0f67ab68?page=18">By Dan Harvey— IMAGE COURTESY OF SIEMENS HEALTH</a> By Dan Harvey— IMAGE COURTESY OF SIEMENS HEALTH<a title="March 2011 - Radiology Today page 19" href="http://viewer.zmags.com/publication/0f67ab68?page=19">A dvancements i</a> A dvancements i<a title="March 2011 - Radiology Today page 20" href="http://viewer.zmags.com/publication/0f67ab68?page=20">Section“Surgery never has to be disrupted,” ad</a> Section“Surgery never has to be disrupted,” ad<a title="March 2011 - Radiology Today page 21" href="http://viewer.zmags.com/publication/0f67ab68?page=21"> Flat-panel detectors have improved patient </a> Flat-panel detectors have improved patient <a title="March 2011 - Radiology Today page 22" href="http://viewer.zmags.com/publication/0f67ab68?page=22">SectionSectionSection— IMAGE COURTE</a> SectionSectionSection— IMAGE COURTE<a title="March 2011 - Radiology Today page 23" href="http://viewer.zmags.com/publication/0f67ab68?page=23">RT0211.q www.RadiologyTod</a> RT0211.q www.RadiologyTod<a title="March 2011 - Radiology Today page 24" href="http://viewer.zmags.com/publication/0f67ab68?page=24">SectionGuidingSectionBIOPSIESSectionBy Beth</a> SectionGuidingSectionBIOPSIESSectionBy Beth<a title="March 2011 - Radiology Today page 25" href="http://viewer.zmags.com/publication/0f67ab68?page=25">were in use across the country. (For com-petitiv</a> were in use across the country. (For com-petitiv<a title="March 2011 - Radiology Today page 26" href="http://viewer.zmags.com/publication/0f67ab68?page=26">Sectionand one with the patient exhaling—and u</a> Sectionand one with the patient exhaling—and u<a title="March 2011 - Radiology Today page 27" href="http://viewer.zmags.com/publication/0f67ab68?page=27">central lumenDESIGNED FOR ACTO TREATMENT STRATE</a> central lumenDESIGNED FOR ACTO TREATMENT STRATE<a title="March 2011 - Radiology Today page 28" href="http://viewer.zmags.com/publication/0f67ab68?page=28">SPEEDSAVES TREVO 2 </a> SPEEDSAVES TREVO 2 <a title="March 2011 - Radiology Today page 29" href="http://viewer.zmags.com/publication/0f67ab68?page=29">SectionSectionI schemic stroke </a> SectionSectionI schemic stroke <a title="March 2011 - Radiology Today page 30" href="http://viewer.zmags.com/publication/0f67ab68?page=30">Sectionright hemiparesis and aphasia, and CT a</a> Sectionright hemiparesis and aphasia, and CT a<a title="March 2011 - Radiology Today page 31" href="http://viewer.zmags.com/publication/0f67ab68?page=31"> Further, the distal access catheter, while </a> Further, the distal access catheter, while <a title="March 2011 - Radiology Today page 32" href="http://viewer.zmags.com/publication/0f67ab68?page=32">MANAGING TO SUCCEEDTRACKING</a> MANAGING TO SUCCEEDTRACKING<a title="March 2011 - Radiology Today page 33" href="http://viewer.zmags.com/publication/0f67ab68?page=33">there are often several layers of qualityassuran</a> there are often several layers of qualityassuran<a title="March 2011 - Radiology Today page 34" href="http://viewer.zmags.com/publication/0f67ab68?page=34">ON THE CASENOT YOUR TYPICALMIGRAINE HEADACHE</a> ON THE CASENOT YOUR TYPICALMIGRAINE HEADACHE<a title="March 2011 - Radiology Today page 35" href="http://viewer.zmags.com/publication/0f67ab68?page=35"> CADASIL is an uncommon, inherited arterial </a> CADASIL is an uncommon, inherited arterial <a title="March 2011 - Radiology Today page 36" href="http://viewer.zmags.com/publication/0f67ab68?page=36">PRODUCTS AND SERVICESCarestream HealthNew Cl</a> PRODUCTS AND SERVICESCarestream HealthNew Cl<a title="March 2011 - Radiology Today page 37" href="http://viewer.zmags.com/publication/0f67ab68?page=37">SOURCECORPCloud-Based DICOM Disaster Recovery So</a> SOURCECORPCloud-Based DICOM Disaster Recovery So<a title="March 2011 - 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