Thunderclap headache attributed to reversible cerebral vasoconstriction: view and review
Open Access
- 31 July 2008
- journal article
- review article
- Published by Springer Science and Business Media LLC in The Journal of Headache and Pain
- Vol. 9 (5), 277-288
- https://doi.org/10.1007/s10194-008-0054-6
Abstract
Thunderclap headache attributed to reversible cerebral vasoconstriction (THARCV) is a syndrome observed in a number of reported cases. In this article we reviewed this new headache entity (idiopathic form) using the clinical-radiological findings of 25 reported patients. In this series of patients 72% were women, the mean age at the onset of first headache episode was 39.4 ± 2.3 years. In addition to the sine qua non condition of being abrupt and severe (thunderclap) at the onset, the headache was usually described as being explosive, excruciating, or crushing. The feature of pulsatility, accompanied or not by nausea was described by 80% of the patients. Forty percent of the cases manifested vomiting and 24% photophobia. Usually the headache was generalized, and in three cases it was unilateral at least at the onset. In 21 of 25 patients (84%) there was at least one recurrence or a sudden increase in the intensity of the headache. A past history of migraine was present in 52% of the patients. Precipitating factors were identified in 56% of the patients. Sexual intercourse was described by six patients. Of the 25 patients with THARCV syndrome studied, 12 (48%) developed focal neurological signs, transitory ischemic attack ( n = 1), or ischemic stroke ( n = 11, 44%), and two (8%) of them manifested seizures. The THARCV syndrome is a neurological disturbance perhaps more frequent than expected, preferentially affecting middle aged female migraineurs, and having an unpredictable prognosis, either showing a benign course or leading to stroke.Keywords
This publication has 89 references indexed in Scilit:
- Small-Vessel VasculitisNew England Journal of Medicine, 1997
- Angiographic Changes Suggestive of Vasospasm in Migraine Complicated by StrokeHeadache: The Journal of Head and Face Pain, 1990
- Persistent segmental cerebral artery constrictions in coital cephalgia.Journal of Neurology, Neurosurgery & Psychiatry, 1990
- Reversible cerebral segmental vasoconstriction.Stroke, 1988
- Abnormalities of interictal cerebral perfusion in classic but not common migraine.Stroke, 1988
- Cerebral vasospasm and eclampsia.Stroke, 1988
- Response of cerebral arteries to sympathetic stimulation during acute hypertension.Hypertension, 1986
- Late-life migraine accompaniments--further experience.Stroke, 1986
- Migraine and Cerebral Infarction; Three Case StudiesHeadache: The Journal of Head and Face Pain, 1985
- Case 35-1985New England Journal of Medicine, 1985