Annihilation headache

Annihilation headaches (primary thunderclap headache , English thunderclap headache ) are suddenly onset, very strong headaches which reach the maximum pain within the first 60 seconds. In contrast to most headaches, annihilation headaches are medical emergencies with a potentially fatal outcome. In industrialized countries, an incidence of 43 per 100,000 adults per year is assumed.

causes

Common causes of annihilation headaches are:

• Subarachnoid hemorrhage : most common cause
• Neurovascular diseases: e.g. B. Reversible Cerebral Vasoconstriction Syndrome (RCVS)
• Infections
• increased intracranial pressure
• decreased intracranial pressure
• cervical artery dissection
• cerebral vein thrombosis

Other possible causes are:

• Intracerebral hematoma
• Intraventricular hemorrhage
• Acute subdural hematoma
• stroke
• Tumors
• Acute sinusitis
• meningitis
• Pituitary infarction
• Cerebral aneurysm without acute bleeding
• Cardiac headache due to myocardial ischemia

Diagnosis

The most common and also the most dangerous cause of the annihilating headache is subarachnoid hemorrhage. This can usually with a skull - CT detected. If the CT is negative, a lumbar puncture is performed. If subarachnoid hemorrhage can be ruled out as the cause, imaging of the cervical and cerebral vessels and an MRI of the brain are performed.

Individual evidence

1. ↑ ^{a b c} Clinical Review: Thunderclap headache. In: BMJ. 2013; 346, p. E8557. doi: 10.1136 / bmj.e8557
2. ^ A. Ducros: Reversible cerebral vasoconstriction syndrome. In: Lancet Neruol. 2012; 11, pp. 906-917.

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !