Abrupt-onset severe headaches.
Thunderclap headache, a severe headache which is maximal in intensity at onset, is associated with numerous underlying disorders, including subarachnoid hemorrhage, unruptured intracranial aneurysm, cervical artery dissection, cerebral venous sinus thrombosis, stroke, intracranial hemorrhage, reversible cerebral vasoconstriction syndrome, and reversible posterior leukoencephalopathy. After exclusion of all possible causes, thunderclap headache may be considered a primary headache. This review summarizes the diagnostic considerations and clinical approach to thunderclap headache, with particular emphasis on the reversible cerebral vasoconstriction syndromes.
Ju
Yo-El S
YE
Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA.
Schwedt
Todd J
TJ
D000208:Acute Disease / Q000628:therapy; D002536:Cerebral Arteries / Q000503:physiopathology*; D003392:Cranial Sinuses / Q000503:physiopathology*; D003937:Diagnosis, Differential; D051270:Headache Disorders, Primary / Q000175:diagnosis* / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D020765:Intracranial Arterial Diseases / Q000150:complications / Q000175:diagnosis; D056784:Leukoencephalopathies / Q000150:complications / Q000175:diagnosis; D012851:Sinus Thrombosis, Intracranial / Q000150:complications / Q000175:diagnosis; D013345:Subarachnoid Hemorrhage / Q000150:complications / Q000175:diagnosis; D020301:Vasospasm, Intracranial / Q000150:complications / Q000175:diagnosis