The unidentified man developed agonising symptoms after trying the "Carolina Reaper" during a hot pepper-eating competition in the US.
He began dry heaving immediately after eating the extremely hot pepper, with the onset of acute head and neck pain hitting him hard. He then developed severe neck pain and agonising headaches, each lasting just a few seconds, over the next several days.
But a closer scan of blood vessels in his head found a peculiar narrowing of arteries in his brain. This condition is characterized by a temporary narrowing of the arteries accompanied by a thunderclap headache.
The first figure shows the man's brain after he staggered into the hospital emergency room; the second was taken five weeks later.
They noted the condition can be caused by a reaction to certain prescription drugs, or after taking illegal drugs. Thunderclap headaches are severe, sudden, with quick pains that strike like a clap of thunder rumbling through your skull.
When you eat a really hot chili pepper, you end up having pain in your stomach. They can be a sign of a brain hemorrhage or a stroke, so doctors take them very seriously.
"But majority will do well with only recurrent headaches, and then they have a total recovery", she added. So in other words, hot peppers are known to have vasoactive properties, meaning that they can affect the size of blood vessels.
Now this pepper, billed as the world's hottest, has made it into a medical journal.
While most RCVS patients do well, she added, a minority can have such severe blood vessel spasms that they die. The fiery punch of peppers is measured in Scoville units. A capsicum, the baseline pepper, has one SHU. Researchers think that given the circumstance, it's likely that in this instance, the problem was caused by the chili pepper - but it's hard to be absolutely sure.
"We are not advising anything against the Carolina Reaper".
The authors of the report advise that RCVS should be considered for patients who experience intense headaches after eating hot peppers, cayenne pepper or any other substance containing high amounts of capsaicin.
"Our patient's symptoms improved with supportive care, he had no further thunderclap headaches", the report said.