Thunderclap headache attributed to reversible cerebral vasoconstriction: view and review

Valença, Marcelo M.; Andrade-Valença, Luciana P. A.; Bordini, Carlos A.; Speciali, José Geraldo

doi:10.1007/s10194-008-0054-6

The Journal of Headache and Pain

Table 3 Clinical and radiological characteristic of 25 reported cases of patients with thunderclap headache attributed to idiopathic reversible cerebral vasoconstriction syndrome

From: Thunderclap headache attributed to reversible cerebral vasoconstriction: view and review

Patient #	Ref. #	Age/gender	History of migraine	Headache and other characteristics	Duration	Precipitating factor	Recurrence	Arteriography (time after headache)	Arterial narrowing	Side	Ischemic stroke	Seizure	Others
1	1	27 F	NR	Bifrontal, generalized, throbbing,nauseas, vomiting	Several hours	Sneeze	1	2 days	Diffuse, AC, PC	bil.	Yes	No	Penicillin hypersensitivity
2	13	39 F	Yes	Pulsatile, nausea	7 days	NR	No	11 days	MCA, ACA, STA	bil.	Yes	Yes
3	37	30 F	Yes	Occipital, nausea, vomiting, abdominal cramps, passage of several diarrheal stools, photophobia	13 days	NR	3	3 weeks	Diffuse, AC, PC	bil.	NR		Worsed with propranolol
4	38	51 F	NR	Throbbing occipital	48 h	NR	1	9 days	Difuse?	Left	Yes	No	Diabetic hypertensive, steroid therapy
5	38	25 M	Yes	Throbbing, forehead bilaterally extending down behind the eyes, photophobia, vomiting	1 h to few days	Sit ups, push-ups, skipping rope	Several	12 days	Parieto-occipital arteries	Left	Yes	No
6	39	48 F	No	Sense of spinning, nausea, vomiting, blurred vision		NR	1	4 days	Diffuse, AC, PC	bil.	Yes	Yes	3 strokes, cortical cerebral artery biopsy normal
7	39	37 F	Yes	Left-side, losing consciousness	6 days	No	No	12 days	Diffuse, AC, PC	bil.	Yes	No
8	39	19 M	NR	Awoke with a frontal and bitemporal headache, nausea, vomiting, photophobia	More than 16 days	Worsened following angiogram	1	5 days	Diffuse, AC, PC	bil.	TIA	No
9	16	27 F	Yes	Throbbing bitemporal, associated with acute onset of right hemiparesis and expressive dysphasia		NR	7	Few days	ICA at C1 vertebral level	Left	Yes	No	Stroke 4 days after discharged with amitriptyline
10	12	30 M	NR	Throbbimg occipital; generalized	6 h	Sexual intercourse, exertion	1	76 h	Diffuse, AC, PC	bil.	No	No
11	10	55 F	NR	Bifrontal, throbbing that later became a dull ache, vomiting	Few hours to 10 days	Orgasm	Several	10 days	Diffuse, AC, PC	bil.	No	No	Improved with clonidine
12	40	36 F	Yes	Throbbing, occipito-nuchal, quichly extended over the entire head and face	3 days	NR	1	8 days	VA + ACA + PCA	bil.	No	No	Prophylactic therapy with propranolol
13	41	30 F	Yes	Abrupt exarcebation with nausea and vomiting, throbbing pain in the right temple	>24 h	Get up to drank some lemonade	No	NR	Calcarine artery	Right	Yes	No
14	14	31 M	Yes?	Associated with vomiting	9 days	NR	1	NR	SCA, MCA	bil.	No	No
15	14	37 F	NR	Abrupt, severe headache	Few hours	NR	1	NR	ACA, MCA	bil.	No	Yes	Asthma. Hypothyroidism + levothyroxine
16	42	26 F	Yes	Pounding, nausea, vomiting, that worsened by standing up associated with visual blurring and photophobia	Several days	NR	NR	Few days?	ACA + MCA	bil.	No	No
17	9	44 F	Yes	Explosive, throbing, global	3 h	Sexual intercourse	1	NR	Diffuse	bil.	Yes	No	Familiar history of sex headache. Hormone replacement. Papilloedema with arteriolar narrowing
18	7	55 F	Yes	Nausea, vomiting, shooting pain in the right occipital, entire cranium	Few hours to 2 days	Straining, bending	4	NR	Diffuse, AC, PC	bil.	Yes?	No
19	7	62 F	Yes	Throbbing, explosive, nausea, supraorbital	1–10 days	Exposure to cold, bending	2	>5 days	ACA + MCA	bil.	No	No	Atrial fibrillation
20	7	60 F	Yes	Excruciating, pulsatile, nausea, photophobia		NR	1	NR	Diffuse, AC, PC	bil.	?	Yes	Lung carcinoma
21	7	38 M	NR	Acute exacerbation of a bifrontal throbbing headache, explosive		Arngiogram	1	3 days	MCA, AComA, PCA	bil.	Yes	No	Prophylactic therapy with propranolol. C6 quadriplegia (diving injury)
22	2	49 M	Yes	Generalized, throbbing, nausea, photophobia, crushing	At least 3 h	Swimming, snorkeling	1	6 days	Diffuse, AC, PC	bil.	No	No
23	2	47 M	No	Holocephalic	Few hours	Sexual intercourse	1	7 days	Diffuse, AC, PC	bil.	No	No
24	11	38 F	No	Pulsatile, vertex	3 days	Sexual intercourse	1	>6 days later	Diffuse, AC, PC	bil.	No	No	Past history of neurocysticercosis
25	8	44 F	Yes	Generalized, throbbing	10–15 min	Sexual intercourse, masturbation	1	6 days	MCA	Right	No	No	Posterior fossa arachnoid cyst

AC anterior circulation, PC posterior circulation, MCA middle cerebral artery, ACA anterior cerebral artery, STA superficial temporal artery, ICA internal carotid artery, VA vertebral artery, PCA posterior cerebral artery, SCA superior cerebelar artery, PComA posterior communicating artery, bil. bilateral

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ISSN: 1129-2377

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