Domzał T, Zaleska B, Walecki J
Kliniki Neurologicznej, Warszawie.
Wiad Lek. 1992 Apr;45(7-8):281-3.
Sudden violent headache occurring for the first time in life suggests subarachnoid haemorrhage and requires diagnostic management. In 20 cases the authors failed to find blood in cerebrospinal fluid, but in 8 cases the protein level was raised. The patients were examined again after 2-10 years, and had control neurological examination and CT of the brain. In half the cases similar headaches returned after various time periods, and haemorrhage was again ruled out. In all patient chronic headaches of lower intensity developed. Control CT examination showed in 7 cases scars or atrophy of brain tissue. It is difficult to qualify such headaches as migraine and other known types of headache. Recently in the literature a new name has been coined for them--thunderclap headaches, and some authors regard them as a sign of minor intracranial haemorrhage. CT changes, raised protein level in cerebrospinal fluid, and the type of pain may suggest haemorrhage. The usefulness of cerebral arteriography in such patients should be considered. We propose the name of stoke headache for suggesting the cause and special management.
一生中首次出现的突发剧烈头痛提示蛛网膜下腔出血，需要进行诊断性处理。在20例患者中，作者未能在脑脊液中发现血液，但有8例患者蛋白质水平升高。在2至10年后对这些患者再次进行检查，并进行了神经系统对照检查和脑部CT检查。半数患者在不同时间段后再次出现类似头痛，再次排除了出血情况。所有患者均出现了强度较低的慢性头痛。对照CT检查显示7例患者存在脑组织瘢痕或萎缩。很难将此类头痛归类为偏头痛或其他已知类型的头痛。最近文献中为它们创造了一个新名称——霹雳样头痛，一些作者将其视为轻微颅内出血的征象。CT改变、脑脊液中蛋白质水平升高以及疼痛类型可能提示出血。应考虑对这类患者进行脑血管造影的效用。我们提议将其命名为卒中样头痛，以提示病因和特殊处理方法。
