Cargando…
Thunderclap Headache: A Primary Symptom of a Steroid-Responsive Encephalopathy with Autoimmune Thyroiditis
Thunderclap headache is frequently associated with serious intracranial vascular disorders and a usual reason for emergency department admissions. Association of thunderclap headaches with autoimmune disorders, such as steroid-responsive encephalopathy with autoimmune thyroiditis (SREAT), is highly...
Autores principales: | , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Hindawi
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137291/ https://www.ncbi.nlm.nih.gov/pubmed/34055433 http://dx.doi.org/10.1155/2021/5517934 |
_version_ | 1783695591346274304 |
---|---|
author | Zala, Naman Wirth, Lena Jordan, Berit Meredig, Hagen Rizos, Timolaos |
author_facet | Zala, Naman Wirth, Lena Jordan, Berit Meredig, Hagen Rizos, Timolaos |
author_sort | Zala, Naman |
collection | PubMed |
description | Thunderclap headache is frequently associated with serious intracranial vascular disorders and a usual reason for emergency department admissions. Association of thunderclap headaches with autoimmune disorders, such as steroid-responsive encephalopathy with autoimmune thyroiditis (SREAT), is highly unusual. Here, we report a patient who presented with high-intensity headache of abrupt onset. Cerebrospinal fluid (CSF) analysis revealed moderate lymphocytic pleocytosis without evidence of infectious, neoplastic, or metabolic causes. Brain magnetic resonance imaging showed no specific pathologies, and examinations for neuronal antibodies in serum and CSF were negative. The medical history revealed that seven years before, an episode of an aseptic meningoencephalitis with remarkable response to steroids was present. Finally, increased levels of serum anti-TPO antibodies were identified, and against the background of a previous steroid-responsive aseptic meningoencephalitis, diagnosis of SREAT was highly probable. Methylprednisolone therapy was initiated, and the patient recovered completely. In particular, because most SREAT patients respond very well to steroids, this case underlines the importance of taking SREAT into consideration during the assessment of a high-intensity headache of abrupt onset. |
format | Online Article Text |
id | pubmed-8137291 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Hindawi |
record_format | MEDLINE/PubMed |
spelling | pubmed-81372912021-05-27 Thunderclap Headache: A Primary Symptom of a Steroid-Responsive Encephalopathy with Autoimmune Thyroiditis Zala, Naman Wirth, Lena Jordan, Berit Meredig, Hagen Rizos, Timolaos Case Rep Neurol Med Case Report Thunderclap headache is frequently associated with serious intracranial vascular disorders and a usual reason for emergency department admissions. Association of thunderclap headaches with autoimmune disorders, such as steroid-responsive encephalopathy with autoimmune thyroiditis (SREAT), is highly unusual. Here, we report a patient who presented with high-intensity headache of abrupt onset. Cerebrospinal fluid (CSF) analysis revealed moderate lymphocytic pleocytosis without evidence of infectious, neoplastic, or metabolic causes. Brain magnetic resonance imaging showed no specific pathologies, and examinations for neuronal antibodies in serum and CSF were negative. The medical history revealed that seven years before, an episode of an aseptic meningoencephalitis with remarkable response to steroids was present. Finally, increased levels of serum anti-TPO antibodies were identified, and against the background of a previous steroid-responsive aseptic meningoencephalitis, diagnosis of SREAT was highly probable. Methylprednisolone therapy was initiated, and the patient recovered completely. In particular, because most SREAT patients respond very well to steroids, this case underlines the importance of taking SREAT into consideration during the assessment of a high-intensity headache of abrupt onset. Hindawi 2021-05-12 /pmc/articles/PMC8137291/ /pubmed/34055433 http://dx.doi.org/10.1155/2021/5517934 Text en Copyright © 2021 Naman Zala et al. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Report Zala, Naman Wirth, Lena Jordan, Berit Meredig, Hagen Rizos, Timolaos Thunderclap Headache: A Primary Symptom of a Steroid-Responsive Encephalopathy with Autoimmune Thyroiditis |
title | Thunderclap Headache: A Primary Symptom of a Steroid-Responsive Encephalopathy with Autoimmune Thyroiditis |
title_full | Thunderclap Headache: A Primary Symptom of a Steroid-Responsive Encephalopathy with Autoimmune Thyroiditis |
title_fullStr | Thunderclap Headache: A Primary Symptom of a Steroid-Responsive Encephalopathy with Autoimmune Thyroiditis |
title_full_unstemmed | Thunderclap Headache: A Primary Symptom of a Steroid-Responsive Encephalopathy with Autoimmune Thyroiditis |
title_short | Thunderclap Headache: A Primary Symptom of a Steroid-Responsive Encephalopathy with Autoimmune Thyroiditis |
title_sort | thunderclap headache: a primary symptom of a steroid-responsive encephalopathy with autoimmune thyroiditis |
topic | Case Report |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8137291/ https://www.ncbi.nlm.nih.gov/pubmed/34055433 http://dx.doi.org/10.1155/2021/5517934 |
work_keys_str_mv | AT zalanaman thunderclapheadacheaprimarysymptomofasteroidresponsiveencephalopathywithautoimmunethyroiditis AT wirthlena thunderclapheadacheaprimarysymptomofasteroidresponsiveencephalopathywithautoimmunethyroiditis AT jordanberit thunderclapheadacheaprimarysymptomofasteroidresponsiveencephalopathywithautoimmunethyroiditis AT meredighagen thunderclapheadacheaprimarysymptomofasteroidresponsiveencephalopathywithautoimmunethyroiditis AT rizostimolaos thunderclapheadacheaprimarysymptomofasteroidresponsiveencephalopathywithautoimmunethyroiditis |