Slivka A, Philbrook B
Department of Neurology, Ohio State University, Columbus 43210.
Headache. 1995 Jan;35(1):1-6. doi: 10.1111/j.1526-4610.1995.hed3501001.x.
Thunderclap headache is an acute high intensity headache similar to that seen in the setting of ruptured saccular aneurysm. We report four patients without subarachnoid hemorrhage who presented with thunderclap headache. Three patients had transient neurologic signs or symptoms. Cerebral angiography revealed diffuse segmental intracerebral arterial vasoconstriction which was reversible in the one patient in whom angiography was repeated. The headaches resolved spontaneously in all cases and after 1 week did not recur. These cases highlight the specific clinical and angiographic features and the self-limited course of patients with thunderclap headache and suggest that thunderclap headache may represent a unique headache category. On the basis of these cases and others reported in the literature, we propose diagnostic criteria for thunderclap headache.
霹雳样头痛是一种急性高强度头痛，类似于囊状动脉瘤破裂时所见的头痛。我们报告了4例无蛛网膜下腔出血但表现为霹雳样头痛的患者。3例患者有短暂的神经系统体征或症状。脑血管造影显示弥漫性节段性脑内动脉血管收缩，在1例重复进行血管造影的患者中这种收缩是可逆的。所有病例的头痛均自发缓解，1周后未复发。这些病例突出了霹雳样头痛患者的特定临床和血管造影特征以及自限性病程，并提示霹雳样头痛可能代表一种独特的头痛类型。基于这些病例及文献中报道的其他病例，我们提出了霹雳样头痛的诊断标准。
