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Thunderclap headache triggered by micturition: responsive to nimodipine
Yuan-Yuan Han1, Wei Gui, Jin Zhu
1Department of Neurology, The First Hospital of Anhui Medical University, Jixi Road 218, Hefei, 230022, China.
The Journal of Headache and Pain
|August 20, 2011
Summary
Primary thunderclap headache (TCH) is rare and usually triggered by exertion. This case highlights micturition as a potential trigger for primary TCH, responding to nimodipine treatment.
Area of Science:
- Neurology
- Headache Medicine
Background:
- Primary thunderclap headache (TCH) is a distinct neurological emergency characterized by abrupt, severe headache onset.
- Common triggers include physical exertion like coughing or sexual activity.
- Micturition is a known trigger for secondary TCH associated with pheochromocytoma, but not typically for primary TCH.
Observation:
- A patient presented with recurrent thunderclap headaches.
- Headaches consistently occurred immediately following micturition.
- This pattern suggested a link between urination and primary TCH in this individual.
Findings:
- The patient's primary TCH episodes were directly linked to micturition.
- Treatment with nimodipine at a therapeutic dosage successfully resolved the headaches.
- This suggests nimodipine may be effective in managing primary TCH triggered by micturition.
Implications:
- Micturition should be considered a potential trigger for primary TCH.
- This case expands the understanding of primary TCH triggers beyond physical exertion.
- Nimodipine may represent a novel therapeutic option for this specific TCH presentation.
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