Review article

Sudden and Severe Headache – a Review of Diagnostic and Therapeutic Guidelines

Zdravka Poljaković

Abstract

Diagnostic criteria of acute intensive headache (thunderclap headache), is an acute intensive headache which reaches maximal intensity within one minute and lasts for more than 5 minutes, no matter what the etiology or accompanied symptoms are. Most often it is an isolated symptom; however, nausea, vomiting, photo or phonophobia, neck stiffness or neck pain, focal neurologic deficit or even disturbances of consciousness may occur. The etiology is most often a neurologic emergency such as: subarachnoid hemorrhage (SAH), reversible intracranial vasoconstriction syndrome (RCVS), thrombosis of cerebral venous sinuses (TCVS), dissection of intra and extracranial blood vessels, intracranial hypotension, infective diseases of the central nervous system, or posterior reversible encephalopathy syndrome (PRES). Some other causes like stroke or intracerebral hematoma are possible, but rare. Benign thunderclap headache is also a possible diagnosis, but only after excluding all mentioned syndromes or states. The therapeutic approach is specific for each particular etiology, bearing in mind that the thunderclap headache is by definition a neurologic emergency and must be diagnosed and treated as an urgent state.

Keywords

thunderclap headache; diagnosis of acute headache; subarachnoid hemorrhage

Hrčak ID:

257510

URI

https://hrcak.srce.hr/257510

Publication date:

17.5.2021.

Article data in other languages: croatian

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