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Advisor(s)
Abstract(s)
A cefaleia em trovoada é uma cefaleia extremamente severa, de início abrupto,
que atinge a máxima intensidade em menos de um minuto, associada a várias condições
com morbilidade e mortalidade significativas, sendo a hemorragia subaracnoide a mais
comum. Os pacientes requerem uma avaliação completa, incluindo anamnese e exame
físico, com ênfase no exame neurológico, visando identificar sinais de alerta para uma
etiologia específica. Uma das causas raras atribuídas a estas cefaleias é o quisto coloide
do terceiro ventrículo, uma malformação congénita benigna que, em alguns casos, pode
culminar em rápida deterioração neurológica e morte súbita.
Esta dissertação oferece uma revisão abrangente das cefaleias em trovoada,
compreendendo uma variedade de condições que podem estar na sua origem, desde as
mais comuns às mais raras. Adicionalmente, discutem-se os meios de diagnóstico
adequados de acordo com o estado da arte, propondo-se um algoritmo de abordagem. O
tratamento varia consoante a causa subjacente, embora seja apresentada uma proposta
terapêutica para cefaleias em trovoada primárias. O quisto coloide do terceiro ventrículo
é examinado em detalhe, abordando as suas características, apresentação clínica,
patogénese, diagnóstico, opções de tratamento e prognóstico.
Apresenta-se um caso de morte súbita resultante de um quisto coloide do terceiro
ventrículo, no qual o paciente apresentou crises recorrentes de cefaleia em trovoada
durante oito meses, culminando em hidrocefalia aguda e, consequentemente, morte.
Com a presente revisão bibliográfica pretende-se reunir uma compreensão
atualizada das cefaleias em trovoada e analisar um caso clínico com essa apresentação,
destacando a relevância de um diagnóstico e intervenção atempados na prevenção da
morbilidade e mortalidade associada a este tipo de cefaleias.
Thunderclap headache is an excruciating headache with an abrupt onset, reaching peak intensity in less than a minute, linked to numerous conditions with notable morbidity and mortality, the most common being subarachnoid hemorrhage. Patients require a thorough evaluation, including anamnesis and physical examination, particularly focusing on neurological assessment, to identify warning signs of a specific etiology. One of the rare causes attributed to these headaches is the colloid cyst of the third ventricle, a benign congenital malformation that, in some cases, may lead to rapid neurological deterioration and sudden death. This dissertation provides a comprehensive review of thunderclap headaches, encompassing a range of conditions that may trigger them, from the common to the rarest. Furthermore, it discusses the current state-of-the-art diagnostic approaches and proposes an algorithm for assessment. Treatment approaches vary depending on the underlying cause, although a therapeutic strategy for primary thunderclap headaches is outlined. Detailed examination of the colloid cyst of the third ventricle is conducted, addressing its characteristics, clinical presentation, pathogenesis, diagnostic methods, treatment options, and prognosis. A case of sudden death resulting from a colloid cyst of the third ventricle is presented, where the patient experienced recurrent episodes of thunderclap headache for eight months, ultimately culminating in acute hydrocephalus and death. The aim of this literature review is to provide an up-to-date understanding of thunderclap headaches and analyze a clinical case demonstrating this presentation, highlighting the importance of timely diagnosis and intervention in preventing the morbidity and mortality linked with this headache type.
Thunderclap headache is an excruciating headache with an abrupt onset, reaching peak intensity in less than a minute, linked to numerous conditions with notable morbidity and mortality, the most common being subarachnoid hemorrhage. Patients require a thorough evaluation, including anamnesis and physical examination, particularly focusing on neurological assessment, to identify warning signs of a specific etiology. One of the rare causes attributed to these headaches is the colloid cyst of the third ventricle, a benign congenital malformation that, in some cases, may lead to rapid neurological deterioration and sudden death. This dissertation provides a comprehensive review of thunderclap headaches, encompassing a range of conditions that may trigger them, from the common to the rarest. Furthermore, it discusses the current state-of-the-art diagnostic approaches and proposes an algorithm for assessment. Treatment approaches vary depending on the underlying cause, although a therapeutic strategy for primary thunderclap headaches is outlined. Detailed examination of the colloid cyst of the third ventricle is conducted, addressing its characteristics, clinical presentation, pathogenesis, diagnostic methods, treatment options, and prognosis. A case of sudden death resulting from a colloid cyst of the third ventricle is presented, where the patient experienced recurrent episodes of thunderclap headache for eight months, ultimately culminating in acute hydrocephalus and death. The aim of this literature review is to provide an up-to-date understanding of thunderclap headaches and analyze a clinical case demonstrating this presentation, highlighting the importance of timely diagnosis and intervention in preventing the morbidity and mortality linked with this headache type.
Description
Keywords
Cefaleia em Trovoada Cefaleia Secundária Hemorragia Subaracnoide Hidrocefalia Quisto Coloide