We report a 17-year-old, right-handed male of Korean descent who, while shopping, developed a sudden onset of palpitations with a general feeling of tremulousness and subsequent flushing.This was followed by a thunderclap headache described as if his entire "head exploded" or the worst pain of his life. This was accompanied by vertigo, nausea, photophobia, dyspnea, and right ocular pain with conjunctival erythema and binocular blurry vision. The latter symptoms improved after 15 minutes. Two days later, he sought medical attention due to improved but persistent occipital and rightsided headache. A head CT and CT angiogram were performed. His CT was unremarkable while his CT angiogram showed multi-vessel irregular narrowing without hemorrhage (Figure 1A). He was transferred to our tertiary center for further evaluation and management.The patient reported a similar episode five months prior. While swimming, he had sudden onset
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