Friday, November 25, 2011

thunderclap headche













A thunderclap headache is a headache that is severe and sudden-onset. It is defined as a severe headache that takes seconds to minutes to reach maximum intensity. It can be indicative of a number of medical problems, most importantly subarachnoid hemorrhage, which can be potentially life-threatening. Usually, further investigations are performed to identify the underlying cause.




Sign and symptom

A headache is called "thunderclap headache" if it is severe in character and reaches maximum severity within seconds to minutes of onset. In many cases, there are no other abnormalities, but the various causes of thunderclap headaches may lead to a number of neurological symptoms. The most important causes are subarachnoid hemorrhage, cerebral venous sinus thrombosis and cervical artery dissection.
Subarachnoid hemorrhage
- Syncope, seizure, visual symptom, vomiting
- Meningism (Kernig’s sign and Brudzinki’s sign)
- Decreased level of consciousness
- Typically persists for several days





Other causes of thunderclap headache
- Subarachnoid hemorrhage (10%-25% of all cases of thunderclap headache)
- Cerebral venous sinus thrombosis
- Cervical artery dissection
- Hypertensive emergency (severely raised blood pressure)
- Spontaneous intracranial hypotension
- Stroke (headache occurs in about 25% of strokes but usually not thunderclap character)
- Retroclival hematoma
- Pituitary apoplexy (infaction or hemorrhage of the pituitary gland)
- Colloid cyst of the third ventricle
- Meningitis (rarely features thunderclap headache)
- Reversible cerebral vasoconstriction syndrome (previously Call-Fleming syndrome, several subtypes)
- Primary cough headache, primary exertional headache and primary sexual headache
- Primary thunderclap headache




Diagnosis
1. CT scan
2. Lumbar puncture ( bloody for 3 days and xantochromic for 3 weeks)
3. MRI
4. MRA
5. Cerebral Angiography

Source – abe wiki and department book.
p/s : artikal ini dikirim oleh abdul rahman... sape2 nak sumbang artikal especially
berkaitan medik amatlah dialu-alukan....

p/s : takziah kepada saudari anis afikah, atas pemergian ayahanda tercinta...
kepada ikhwah2 sekalian, lepas solat jumaat ( 25/11 ), ada majlis tahlil dan
sebagainya,,,, rujuk FB sc wira...

Mentaqarrub diri kepada Allah,profesional doktor dalam genggaman