Is vasospasm requisite for posterior leukoencephalopathy in patients with primary thunderclap headaches?

S. P. Chen, J. L. Fuh, J. F. Lirng, S. J. Wang*

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

33 Scopus citations

Abstract

Primary thunderclap headache (TCH) is sometimes associated with cerebral vasospasm. However, the role of vasospasm in relation to the development of reversible or irreversible posterior leukoencephalopathy among patients with primary TCH has never been fully addressed. This paper includes a report on a 51-year-old woman with primary TCH complicated with posterior leukoencephalopathy and a literature review of 16 further patients with the same illness. Their magnetic resonance or conventional angiographic findings were clearly described. Our review found that all these 17 patients showed evidence of cerebral vasospasm. Eleven (65%) of them developed permanent ischaemic infarctions, almost exclusively located at the watershed zones. We suggest that the presence of vasospasm might be requisite for posterior leukoencephalopathy as well as for permanent infarctions in these patients. Therefore, searching for any clue of vasospasm is mandatory in treatment of patients with primary TCH. Absence of an accompanying vasospasm might predict a good outcome.

Original languageEnglish
Pages (from-to)530-536
Number of pages7
JournalCephalalgia
Volume26
Issue number5
DOIs
StatePublished - May 2006

Keywords

  • Reversible posterior leukoencephalopathy syndrome
  • Thunderclap headache
  • Vasospasm

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