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Secondary causes of thunderclap headache

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

secondary causes of thunderclap headaches

An underlying cause should be considered in any patient with thunderclap headache even with a history of recurrent headaches (such as migraine).

  • subarachnoid hemorrhage
    • most common cause
    • around 50% of patients presents with thunderclap pattern of headache
    • subarachnoid haemorrhage is found in 11-25% of 50%.8-11 Subarachnoid haemorrhage is found in 11-25% of patients who present with thunderclap headache (1)

  • sentinel headache
  • reversible cerebral vasoconstriction syndrome
  • cerebral venous sinus thrombosis
  • cervical artery dissection
  • spontaneous intracranial hypotension
  • acute hypertensive crisis
  • intracerebral haemorrhage
  • pituitary apoplexy
  • brain infarct
  • hydrocephalus (aqueductal stenosis, Chiari type 1 malformation)
  • tumour (third ventricle colloid cyst, posterior fossa tumour)
  • ischemic stroke
  • primary cough, sexual, and exertional headache
  • myocardial infarction
  • pheochromocytoma

Reference:

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