Relevância clínica de variantes congênitas da circulação posterior em cefaleia induzida por esforço: relato de Caso

Cecília  Lima Garcia; Jerônimo de Assis Garcia Neto; Ana Maria Raganini Dalmaso; Guilherme Arruda Vilela; José Martins de Souza Neto; Luís Henrique Lima da Silva

doi:10.37951/2675-5009.2025v6i18.183

Authors

Cecília Lima Garcia Residente Clínica Médica Universidade Federal de Jataí, Jataí/GO, Brasil. Author https://orcid.org/0009-0008-6756-5512
Jerônimo de Assis Garcia Neto Centro Universitário de Mineiros Author https://orcid.org/0009-0002-1911-510X
Ana Maria Raganini Dalmaso Residente Clínica Médica Universidade Federal de Jataí, Jataí/GO, Brasil. Author https://orcid.org/0009-0003-9734-8993
Guilherme Arruda Vilela Médico Diretor da UPA - Unidade de Pronto Atendimento, Jataí/GO, Brasil. Author https://orcid.org/0009-0003-1040-6936
José Martins de Souza Neto Médico Preceptor da Residência de Clínica Médica Universidade Federal de Jataí, Jataí/GO, Brasil Author https://orcid.org/0009-0000-2428-7710
Luís Henrique Lima da Silva Residente Clínica Médica Universidade Federal de Jataí, Jataí/GO, Brasil. Author https://orcid.org/0000-0001-9089-3129

DOI:

https://doi.org/10.37951/2675-5009.2025v6i18.183

Keywords:

Headache, Congenital vascular anomaly, Fetal pattern, Vertebral artery hypoplasia, Physical exertion

Abstract

Case report of a young adult with headache triggered by intense physical exertion who was found to have congenital posterior circulation variants, including fetal-type posterior cerebral artery and vertebral artery hypoplasia. The patient presented with unilateral pressure-like headache, photophobia, visual scotomas, and paresthesias after vigorous exercise, without symptoms during mild to moderate activity. Laboratory tests and brain CT were unremarkable. Angio–MRI revealed right fetal-type PCA and left vertebral artery hypoplasia. Current literature provides limited evidence regarding the relationship between these variants and non-ischemic manifestations such as exertional headache. This case highlights the potential hemodynamic implications of posterior circulation variants and reinforces the need for further research on their clinical significance.