American Board of Internal Medicine (ABIM) Certification Practice Exam

What is a common neurological finding in patients diagnosed with cerebral vasoconstriction syndrome?

1. Vasodilation of cerebral arteries

2. Thunderclap headaches

3. Altered mental status only

4. Epileptic seizures only

The correct answer is: Thunderclap headaches

In patients diagnosed with cerebral vasoconstriction syndrome, a common neurological finding is the presence of thunderclap headaches. These headaches are characterized by a sudden onset, often reaching peak intensity within seconds to minutes, and can be quite severe. Thunderclap headaches are significant because they may serve as a warning sign of underlying vascular issues, such as cerebral vasoconstriction or even the potential for more serious complications like subarachnoid hemorrhage. Cerebral vasoconstriction syndrome often leads to recurrent headaches due to the transient narrowing of the cerebral arteries which can cause ischemia and resulting pain. This type of headache is a hallmark symptom in the clinical presentation of the syndrome and helps differentiate it from other headache disorders. Other options, such as vasodilation of cerebral arteries, altered mental status, or only experiencing epileptic seizures, do not accurately represent the typical findings associated with this condition. Thunderclap headaches, on the other hand, play a critical role in alerting healthcare professionals to the underlying vascular pathology present in these patients.