Evaluating thunderclap headache

Chen, Chun-Yu; Fuh, Jong‐Ling

doi:10.1097/wco.0000000000000917

Cited by 8 publications

(5 citation statements)

References 62 publications

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“…65 ) For patients presenting within 6 hours of headache onset who have no new neurological deficits, the lack of SAH on a noncontrast head CT is likely sufficient to exclude aSAH. 50–53 This question was evaluated in a 2016 meta-analysis in which 8907 patients were studied. Thirteen patients had a missed SAH on head CT performed within 6 hours, leading to a sensitivity of 98.7% and specificity of 99.9%.…”

Section: Clinical Manifestations and Diagnosis Of Asahmentioning

confidence: 99%

“…Another analysis estimated the sensitivity of CTA for ruptured aneurysms <3 mm at 61%. 64 Given the severe morbidity and potential mortality associated with a missed aSAH [50][51][52][53] This question was evaluated in a 2016 meta-analysis in which 8907 patients were studied. Thirteen patients had a missed SAH on head CT performed within 6 hours, leading to a sensitivity of 98.7% and specificity of 99.9%.…”

Section: Synopsismentioning

confidence: 99%

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2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Hoh¹,

Ko²,

Amin‐Hanjani³

et al. 2023

Stroke

260

145

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AIM: The “2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage” replaces the 2012 “Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage.” The 2023 guideline is intended to provide patient-centric recommendations for clinicians to prevent, diagnose, and manage patients with aneurysmal subarachnoid hemorrhage. METHODS: A comprehensive search for literature published since the 2012 guideline, derived from research principally involving human subjects, published in English, and indexed in MEDLINE, PubMed, Cochrane Library, and other selected databases relevant to this guideline, was conducted between March 2022 and June 2022. In addition, the guideline writing group reviewed documents on related subject matter previously published by the American Heart Association. Newer studies published between July 2022 and November 2022 that affected recommendation content, Class of Recommendation, or Level of Evidence were included if appropriate. STRUCTURE: Aneurysmal subarachnoid hemorrhage is a significant global public health threat and a severely morbid and often deadly condition. The 2023 aneurysmal subarachnoid hemorrhage guideline provides recommendations based on current evidence for the treatment of these patients. The recommendations present an evidence-based approach to preventing, diagnosing, and managing patients with aneurysmal subarachnoid hemorrhage, with the intent to improve quality of care and align with patients’ and their families’ and caregivers’ interests. Many recommendations from the previous aneurysmal subarachnoid hemorrhage guidelines have been updated with new evidence, and new recommendations have been created when supported by published data.

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Section: Clinical Manifestations and Diagnosis Of Asahmentioning

confidence: 99%

Section: Synopsismentioning

confidence: 99%

2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Hoh¹,

Ko²,

Amin‐Hanjani³

et al. 2023

Stroke

260

145

View full text Add to dashboard Cite

show abstract

“…Other signs and symptoms that should be investigated are nausea, vomiting, visual disorders, hypertension (blood pressure > 140/90 mmHg), papilledema, confusional state, fever and focal neurological signs (paresthesia or weakness of arm or leg, facial weakness, speech disturbance, ataxic gait, paresis, abnormal eye movement, etc.) [99].…”

Section: Headachementioning

confidence: 99%

“…Thunderclap headache (TCH) is an abrupt onset of severe headache that needs to be thoroughly investigated because the most common secondary cause is subarachnoid hemorrhage (SAH) [99]. The first step to investigating an SAH is to perform a cerebral CT without contrast medium.…”

Section: Headachementioning

confidence: 99%

Neurological Complications in Pregnancy and the Puerperium: Methodology for a Clinical Diagnosis

Merlino¹,

Alba²,

D’Ovidio³

et al. 2023

JCM

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Neurological complications in pregnancy and the puerperium deserve particular attention from specialists due to the worsening of the clinical picture for both the mother and the fetus. This narrative review of existing data in the literature aims to analyze the most common “red flag symptoms” attributable to neurological complications such as pre-eclampsia (PE), eclampsia, HELLP syndrome, posterior reversible encephalopathy syndrome (PRES), cerebral vasoconstriction syndrome (RCVS), stroke, CVS thrombosis, pituitary apoplexy, amniotic fluid embolism and cerebral aneurysm rupture, with the aim of providing a rapid diagnostic algorithm useful for the early diagnosis and treatment of these complications. The data were derived through the use of PubMed. The results and conclusions of our review are that neurological complications of a vascular nature in pregnancy and the puerperium are conditions that are often difficult to diagnose and manage clinically. For the obstetrics specialist who is faced with these situations, it is always important to have a guide in mind in order to be able to unravel the difficulties of clinical reasoning and promptly arrive at a diagnostic hypothesis.

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“…Thunderclap headache was first coined by Day and Raskin in the 1980s to describe a patient who developed an abrupt and severe headache that they considered to result from an unruptured aneurysm (38). In addition to primary HSA (13), numerous etiologies of thunderclap headache have been identified (39–41), including SAH (42,43), RCVS (26), cervicocephalic artery dissection (44), CVT (45), cerebral infarction (43,46), intracerebral hemorrhage (43), meningitis (43), spontaneous intracranial hypotension (47), acute hypertensive crisis (48), pituitary apoplexy (49), aqueduct stenosis (50), giant cell arteritis (51), etc. Based on the ICHD-3 (2018) criteria for 4.4 Primary thunderclap headache (Table 4), not until all secondary causes and other ICHD-3 diagnoses have been demonstrably excluded can primary thunderclap headache be diagnosed (1).…”

Section: Introductionmentioning

confidence: 99%

Update on primary headache associated with sexual activity and primary thunderclap headache

Lin

Chen

2023

Cephalalgia

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Background This narrative review aims to provide an update on primary headache associated with sexual activity and primary thunderclap headache. Methods We conducted a literature search on PubMed with the keywords “headache associated with sexual activity”, “sexual headache”, “orgasmic cephalalgia”, and “coital cephalalgia” in addition to “thunderclap headache” to assess the appropriateness of all published articles in this review. Results Primary headache associated with sexual activity is a “primary” headache precipitated by sexual activity, which occurs as sexual excitement increases (progressive at onset), or manifests as an abrupt and intense headache upon orgasm (thunderclap at onset) or combines these above two features. Primary headache associated with sexual activity is diagnosed after a thorough investigation, including appropriate neuroimaging studies, to exclude life-threatening secondary causes such as subarachnoid hemorrhage. According to the criteria of the third edition of the International Classification of Headache Disorders, primary thunderclap headache is also a diagnosis by exclusion. The pathophysiology of primary headache associated with sexual activity and primary thunderclap headache remains incompletely understood. Treatment may not be necessary for all patients since some patients with primary headache associated with sexual activity and primary thunderclap headache have a self-limiting course. Conclusion A comprehensive neuroimaging study is needed for distinguishing primary headache associated with sexual activity or primary thunderclap headache from secondary causes. Primary headache associated with sexual activity and primary thunderclap headache are self-limited diseases and the prognoses are good, but some patients with primary headache associated with sexual activity may have a prolonged course.

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Evaluating thunderclap headache

Cited by 8 publications

References 62 publications

2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

2023 Guideline for the Management of Patients With Aneurysmal Subarachnoid Hemorrhage: A Guideline From the American Heart Association/American Stroke Association

Neurological Complications in Pregnancy and the Puerperium: Methodology for a Clinical Diagnosis

Update on primary headache associated with sexual activity and primary thunderclap headache

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