Nimodipine for treatment of primary thunderclap headache

Lu, Shiang Ru; Liao, Yi‐Chu; Fuh, Jong‐Ling; Lirng, Jiing Feng; Wang, S. J.

doi:10.1212/01.wnl.0000120669.85649.77

Cited by 123 publications

(105 citation statements)

References 10 publications

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“…Some patients were reported previously. 6,8,13 A total of 56 patients (51 female/5 male, mean age 49.6 Ϯ 9.8 [range 22 to 76] years) with recurrent thunderclap headache without known causes were eligible for the final analysis. Most patients (80%) were aged between 40 and 60 years.…”

Section: Resultsmentioning

confidence: 99%

Pulsating enophthalmos in an adult patient with type 1 neurofibromatosis

Rufa¹,

Zicari²,

Cerase³

et al. 2006

Neurology

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Abstract-Objectives:To investigate the clinical pictures of patients with recurrent thunderclap headaches of unknown etiology and to field-test two relevant International Classification of Headache Disorders, 2nd edition (ICHD-II) criteria, i.e., primary thunderclap headache (Code 4.6) and benign (or reversible) angiopathy of the CNS (Code 6.7.3). Methods: We prospectively recruited patients presenting with idiopathic recurrent thunderclap headaches from a hospital-based headache clinic. Detailed histories, neurologic examinations, and MRIs and magnetic resonance angiographies (MRAs) were performed in all patients to exclude secondary causes. Patients with cerebral vasoconstriction received serial MRA follow-up. Results: Fifty-six consecutive patients (51 female/5 male, mean age 49.6 Ϯ 9.8 [range 22 to 76] years) were enrolled. Segmental vasoconstriction (or benign CNS angiopathy) was found in 22 patients (39%). Thunderclap headache recurred in all patients with a median frequency of 0.7 times per day for a median period of 14 days (range 6 to 86 days). The median duration for each single attack was 3 hours. Most patients (84%) reported at least one trigger. Nimodipine effectively aborted further attacks in 83% of the treated patients. Headache attacks subsided within 3 months. Four patients (7%) developed ischemic complications. Patients with and without vasoconstriction based on MRA images were similar regarding demographics and headache profile. Except for the duration criterion, our patients generally mapped well into the proposed ICHD-II criteria. Conclusions: This study suggests that the two diagnostic entities proposed by the ICHD-II may present different spectra of the same disorder. The distinct headache profile may help physicians quickly recognize this disabling headache disorder with risk of stroke and provide timely treatment.

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Section: Resultsmentioning

confidence: 99%

Pulsating enophthalmos in an adult patient with type 1 neurofibromatosis

Rufa¹,

Zicari²,

Cerase³

et al. 2006

Neurology

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“…Oral and intravenous nimodipine may be effective [8]. A long-term follow-up of patients with recurrent PTCH showed that individuals had substantial impairment in their working capacity and social functioning [9].…”

Section: Discussionmentioning

confidence: 99%

Persistent primary thunderclap headache responsive to gabapentin

Garza

Black

2006

J Headache Pain

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We report the case of a woman with an apparent primary thunderclap headache which occurred frequently until she achieved a therapeutic dosage of gabapentin. Primary thunderclap headache is a rare type of headache that warrants significant testing to rule out more ominous possibilities. Whether gabapentin may help other primary thunderclap headache sufferers or not remains unclear. Further research is needed.

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“…A recent case report demonstrated that indomethacin might cause reversible cerebral vasoconstriction phenomena, and should be used with caution in acute treatment of headache [56]. The calcium-channel blocker nimodipine has been shown to be effective in aborting the headaches in 64-83% of patients in open-label series [12,15,57]. A recent retrospective study demonstrated that monotherapy with calcium-channel blockers is associated with good outcome [17].…”

Section: Therapeutic Strategiesmentioning

confidence: 99%