Table 3.
Thunderclap headache
| Publication | N | Mean Follow-up (years) | Past TCHA % | Recurrent TCHA % | Subsequent primary HA % | Prior primary HA% | Precipitant to onset | Duration | Additional features (%) |
|---|---|---|---|---|---|---|---|---|---|
|
Wijdicks 1988 [22] PTCHA |
71 | 3.3 | 10 | 17 | 44 | – | Cough 7%, sex 4%, other exertion 17%, light tasks 72% |
8–24 h median Range 1 h to 1 week |
Vomiting (38), diplopia (3), stiff neck (14), dilated pupil (1) |
|
Harling 1989 [23] PTCHA |
14 | 1.5 to 2.5 (no mean given) | – | – | 93 | 28 | Exercise, weights, sex 21% |
< 2 h 0% > 2 h 79% |
Vomiting (28) (P < 0.02), Neck stiffness (57) Photophobia (64) Loss of consciousness (14) |
| Harling 1989 SAH | 35 | – | – | – | 43 | Exercise, weights, sex 28% | – |
Vomiting (72) Neck stiffness (80) Photophobia (57) Loss of consciousness (34) |
|
|
Markus [24] PTCHA |
18 | 1.7 | 25 | 25 | 50 | 38 |
N (19%) Sex 1 Straining 1 Lifting 0 Diving 1 |
– |
Nausea (88) Vomiting (44) Photophobia (50) Collapse (6) |
|
Markus 1991 SAH |
37 | – | 60 | – | – | – |
N (18%) Sex 1 Straining 0 Lifting 1 Diving 1 |
– |
Nausea (60) Vomiting (68) Photophobia (5) Collapse (16) |
|
Linn 1998 [8] PTCHA |
42 | Data from first presentation only | 14 | – | – | 57 | Exertion/Valsalva 22% | – |
Nausea (76) Vomiting (43) Transient loss/clouding of consciousness (16) Transient focal symptoms* (22) Seizure 0% |
|
Linn 1998 SAH |
37 | 19 | – | – | 38 | Exertion/Valsalva 50% | – |
Nausea (76) Vomiting (69) Transient loss/clouding of consciousness (26) Transient focal symptoms* (33) Seizure (7) |
|
|
Landtblom 2002 [9] PTCHA |
101 | 1 | 29 | 24 | – |
28 Migraine 25 TTH |
Exertion/Valsalva 21% Sexual TCHA 9% |
– |
Nausea (91) Neck stiffness (61) Paresis (13) Impaired consciousness (17) Unconsciousness (17) Photophobia (9) Blurred vision (4) Scintillation scotoma (0) Diplopia (0) |
| Landtblom 2002 SAH | 23 | – | 17 | – | – |
22 Migraine 9 TTH |
Exertion/Valsalva 17% Sexual TCHA 9% |
– |
Nausea (61) Neck stiffness (10) Paresis (3) Impaired consciousness (9) Unconsciousness (4) Photophobia (4) Blurred vision (4) Scintillation scotoma (7) Diplopia (2) |
PTCHA Primary thunderclap headache, SAH Subarachnoid haemorrhage
*Transient neurological symptoms—double vision, speech arrest, sensory phenomena or weakness in the face or limbs (unilateral or bilateral), and difficulties with walking