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Emergency Room Headache: A Case with Primary Thunderclap Headache Including Differential Diagnosis from Secondary Ones

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Case-Based Diagnosis and Management of Headache Disorders

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Abstract

A 41-year-old man was admitted to the general emergency room (ER) because of an extremely severe headache of instantaneous onset (1 min at most), probably the worst ever in his life. He had described of having two previous similar episodes within a few days all during sexual intercourse, including the final one that brought him to the ER.

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Suggested Reading

  1. Al-Shahi R, White PM, Davenport RJ, Lindsay KW (2006) Subarachnoid haemorrhage. BMJ 333:235–40

    Article  PubMed Central  PubMed  Google Scholar 

  2. Broner S, Lay C, Newman L, Swerdlow M (2007) Thunderclap headache as the presenting symptom of myocardial infarction. Headache 47:724–5

    Article  PubMed  Google Scholar 

  3. Cough JR (2001) Orgasm headache. Headache 41:512–514

    Article  Google Scholar 

  4. Cough J, Bearss C (1990) Relief of migraine with sexual intercourse. Headache 30:302

    Google Scholar 

  5. Cumurciuc R, Crassard I, Sarov M, Valade D, Bousser MG (2005) Headache as the only neurological sign of cerebral venous thrombosis: a series of 17 cases. J Neurol Neurosurg Psychiatry 76:1084–7

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Davenport R (2002) Acute headache in the emergency department. J Neurol Neurosurg Psychiatry 72:ii33–ii7

    PubMed Central  PubMed  Google Scholar 

  7. Day JW, Raskin NH (1986) Thunderclap headache: symptom of enraptured cerebral aneurysm. Lancet 2:1247–8

    CAS  PubMed  Google Scholar 

  8. De Bruijn SF, Stam J, Kappelle LJ, CVST Study Group (1996) Thunderclap headache as first symptom of cerebral venous sinus thrombosis. Lancet 348:1623–5

    Article  PubMed  Google Scholar 

  9. Dodick DW (2002) Thunderclap headache. J Neurol Neurosurg Psychiatry 72:6–11

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  10. Dodick DW, Wijdicks EF (1998) Pituitary apoplexy presenting as a thunderclap headache. Neurology 50:1510–1

    Article  CAS  PubMed  Google Scholar 

  11. Ducros A (2012) Reversible cerebral vasoconstriction syndrome. Lancet Neurol 11:906–17

    Article  PubMed  Google Scholar 

  12. Ducros A, Boukobza M, Porcher R, Sarov M, Valade D, Bousser MG (2007) The clinical and radiological spectrum of reversible cerebral vasoconstriction syndrome. A prospective series of 67 patients. Brain 130:3091–101

    Article  PubMed  Google Scholar 

  13. Ducros A, Fiedler U, Porcher R, Boukobza M, Stapf C, Bousser MG (2010) Hemorrhagic manifestations of reversible cerebral vasoconstriction syndrome. Frequency, features, and risks factors. Stroke 41:2505–11

    Article  PubMed  Google Scholar 

  14. Evans RW, Pascual J (2000) Orgasmic headache: clinical diagnosis and treatment. Headache 40:491–494

    Article  CAS  PubMed  Google Scholar 

  15. Evers S, Lance JW (2006) In primary headache attributed to sexual activity. In: Olesen J, Goabsy PJ, Ramadan NM et al (eds) The headaches, 3rd edn. Lippincott William & Wilkins, Philadelphia, pp 841–846

    Google Scholar 

  16. Frese A, Eikermann A, Frese K et al (2003) Headache associated with sexual activity. Demography, clinical features and comorbidity. Neurology 61:796–800

    Article  CAS  PubMed  Google Scholar 

  17. Frese A, Frese K, Ringelstein EB, Husstedt I-W, Evers S (2003) Cognitive processing in headache associated with sexual activity. Cephalalgia 23:545–551

    Article  CAS  PubMed  Google Scholar 

  18. Fugate JE, Ameriso SF, Ortiz G, Schottlaender LV, Wijdicks EF, Flemming KD et al (2012) Variable presentations of postpartum angiopathy. Stroke 43:670–6

    Article  PubMed  Google Scholar 

  19. Headache Classification Committee of the international Headache Society (2013) The international classification of headache disorders. (ICHD-3beta). Cephalalgia 33(9):628–808

    Article  Google Scholar 

  20. Landtblom AM, Fridriksson S, Boivie J, Johansson G, Johansson I (2002) Sudden onset headache: a prospective study of features, incidence and causes. Cephalalgia 22:354–60

    Article  PubMed  Google Scholar 

  21. Lasoasa DS (2003) Not so benign sexual headache. Cephalalgia 34:808

    Google Scholar 

  22. Linn FH, Rinkel GJ, Algra A, van Gijn J (1998) Headache characteristics in subarachnoid haemorrhage ad benign thunderclap headache. J Neurol Neurosurg Psychiatry 65:791–3

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  23. Linn FH, Wijdicks EF, van der Graaf Y, Weedesteyn-van Vliet FA, Bartelds A, van Gijn J (1994) Prospective study of sentinel headache in aneurismal subarachnoid haemorrhage. Lancet 344:590–3

    Article  CAS  PubMed  Google Scholar 

  24. Lopes Azevedo L, Breder R, de Freitas GR, de A Santos DP (2011) Ischemic stroke presenting as thunderclap headache: report of two cases and review of the literature. Eur Neurol 66:133–5

    Article  PubMed  Google Scholar 

  25. MgGeeney BE, Barest G, Grillone G (2006) Thunderclap headache from complicated sinusitis. Headache 46:517–20

    Article  Google Scholar 

  26. Mistry N, Mathew L, Parry A (2009) Thunderclap headache. Pract Neurol 9:294–7

    Article  PubMed  Google Scholar 

  27. Moussouttas M, Mayer SA (2008) Thunderclap headache with normal CT and lumbar puncture: further investigations are unnecessary: against. Stroke 39:1394–5

    Article  PubMed  Google Scholar 

  28. O’Neill J, McLaggan S, Gibson R (2005) Acute headache and subarachnoid haemorrhage: a retrospective review of CT and lumbar puncture findings. Scott Med J 50:151–3

    PubMed  Google Scholar 

  29. Pascual J, Iglesias F, Oterino A et al (1996) Exertional and sexual headaches: an analysis of 72 benign and symptomatic cases. Neurology 46:1520–1524

    Article  CAS  PubMed  Google Scholar 

  30. Savitz SI, Edlow J (2008) Thunderclap headache with normal CT and lumbar puncture: further investigations are unnecessary: for. Stroke 39:1392–3

    Article  PubMed  Google Scholar 

  31. Schievink WI, Thompson RC, Loh CT, Maya MM (2001) Spontaneous retroclival hematoma presenting as a thunderclap headache. Case report. J Neurosurg 95:522–4

    Article  CAS  PubMed  Google Scholar 

  32. Schievink WI, Wijdicks EF, Meyer FB, Sonntag VK (2001) Spontaneous intracranial hypotension mimicking aneurismal subarachnoid haemorrhage. Neurosurgery 48:513–6, discussion 6-7

    Article  CAS  PubMed  Google Scholar 

  33. Schwedt TJ, Matharu MS, Dodick DW (2006) Thunderclap headache. Lancet Neurol 5:621–31

    Article  PubMed  Google Scholar 

  34. Silbert PL, Edis HR, Stewart-Wynn EGG, Gubbay SS (1991) Benign vascular sexual headache and exertional headache: inter-relationships and long term prognosis. J Neurol Neurosurg Psychiatr 54:417–421

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  35. Singhal AB, Hajj-Ali RA, Topcuoglu MA, Fok J, Bena J, Yang D et al (2011) Reversible cerebral vasoconstriction syndromes :analysis of 139 cases. Arch Neurol 68:1005–12

    Article  PubMed  Google Scholar 

  36. Timoteo A, Inacio N, Machado S, Pinto AA, Parreira E (2012) Headache as the sole presentation of cerebral venous thrombosis: a prospective study. J Headache Pain 13:487–90

    Article  PubMed Central  PubMed  Google Scholar 

  37. Yeh YC, Fuh JL, Chen SP, Wang SJ (2010) Clinical features, imaging findings and outcomes of headache associated with sexual activity. Cephalalgia 30:1329–35

    Article  PubMed  Google Scholar 

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Correspondence to Dominique Valade .

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Valade, D. (2015). Emergency Room Headache: A Case with Primary Thunderclap Headache Including Differential Diagnosis from Secondary Ones. In: Siva, A., Lampl, C. (eds) Case-Based Diagnosis and Management of Headache Disorders. Headache. Springer, Cham. https://doi.org/10.1007/978-3-319-06886-2_26

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  • DOI: https://doi.org/10.1007/978-3-319-06886-2_26

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-06885-5

  • Online ISBN: 978-3-319-06886-2

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