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Thunderclap headache durch Kleinhirninfarkt

Thunderclap headache caused by cerebellar infarction

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Zusammenfassung

Der „thunderclap headache“ ist ein hyperakuter Kopfschmerz von sehr starker Schmerzintensität. Oft ist er das erste Zeichen einer lebensbedrohlichen neurovaskulären Erkrankung. Es wird der Fall eines 44-jährigen Mannes beschrieben, der einen thunderclap headache als isoliertes klinisches Symptom aufwies. Die klinische Untersuchung zeigte keine weiteren fokalen motorischen oder sensiblen Ausfälle. Routineblutuntersuchung, zerebrale Computertomographie (CCT) sowie Liquoranalyse erbrachten keine pathologischen Resultate. Ein zerebrales Magnetresonanztomogramm (MRT) zum Ausschluss eines symptomatischen thunderclap headache zeigte einen ischämischen Kleinhirninfarkt rechts. Dieser Fall verdeutlicht die Notwendigkeit eines zerebralen MRT zur Einschätzung der betroffenen Patienten, auch dann, wenn die neurologisch-klinische Untersuchung, die zerebrale CT und Liquoranalyse Normalbefunde zeigen.

Abstract

Thunderclap headache is an acute and severe headache and is often the first sign of a life-threatening neurovascular disorder. The case of a 44-year-old man is described who presented with a thunderclap headache as the only clinical symptom. The clinical examination did not reveal any other focal deficits or signs of motor or sensory failures. Routine blood tests, cerebral CT as well as cerebrospinal fluid analysis showed no pathological results. A cerebral MRI to exclude a symptomatic thunderclap headache revealed a right cerebellar infarction. This case expands the differential diagnosis of thunderclap headache and reinforces the need for magnetic resonance imaging in the evaluation of such patients, even when neurological examination, cerebral CT, and cerebrospinal fluid analysis are normal.

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Authors and Affiliations

  1. Universitätsschmerzzentrum, Universitätsklinikum der TU Dresden, Fetscherstr. 74, 01309, Dresden, Deutschland

    G. Goßrau & R. Sabatowski

  2. Klinik für Neurologie, Medizinische Fakultät der TU Dresden, Dresden, Deutschland

    G. Goßrau & H. Reichmann

  3. Abteilung für Neuroradiologie, Medizinische Fakultät der TU Dresden, Dresden, Deutschland

    C. Dannenberg

Authors
  1. G. Goßrau
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  2. C. Dannenberg
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  3. H. Reichmann
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  4. R. Sabatowski
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Correspondence to G. Goßrau.

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Goßrau, G., Dannenberg, C., Reichmann, H. et al. Thunderclap headache durch Kleinhirninfarkt. Schmerz 22, 82–86 (2008). https://doi.org/10.1007/s00482-007-0604-x

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  • DOI: https://doi.org/10.1007/s00482-007-0604-x

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