Current neurology and neuroscience reports
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Curr Neurol Neurosci Rep · Mar 2007
ReviewThunderclap headache: an approach to a neurologic emergency.
Thunderclap headache (TCH) refers to an excruciating headache of instantaneous onset. Recognition and accurate diagnosis of this headache are important because it can be caused by various serious underlying brain disorders such as subarachnoid hemorrhage, intracranial hematoma, cerebral venous sinus thrombosis, cervical artery dissection, ischemic stroke, pituitary apoplexy, acute arterial hypertension, spontaneous intracranial hypotension, third ventricle colloid cyst, and intracranial infections. ⋯ Primary TCH is diagnosed when no underlying etiology is identified. In this review, we discuss the differential diagnosis of TCH, outline the characteristics and diagnostic criteria for primary TCH, offer a pathophysiologic hypothesis for primary TCH, and detail the diagnostic evaluation of the patient presenting with TCH.
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Curr Neurol Neurosci Rep · Mar 2007
ReviewTrigeminal autonomic cephalalgias: diagnosis and treatment.
The trigeminal autonomic cephalalgias (TACs) are a group of primary headache disorders characterized by unilateral head pain that occurs in association with ipsilateral cranial autonomic features. The TACs include cluster headache, paroxysmal hemicrania, and short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT) and its close relative short-lasting unilateral neuralgiform headache attacks with cranial autonomic symptoms (SUNA). ⋯ They are distinguished by the frequency of attacks of pain, the length of the attacks, and very characteristic responses to medical therapy, such that the diagnosis can usually be made clinically, which is important because it completely dictates therapy. The management of TACs can be very rewarding for physicians and highly beneficial to patients.