Description

Thunderclap headaches for the height of his name, strike suddenly like a clap of thunder. The pain of these headaches are severe peaks within 60 seconds.

Thunderclap headaches are rare, but they can warn of potential life-threatening conditions — that usually has to do with bleeding in the brain. Seek emergency medical attention for a thunderclap headache.

Symptoms

Thunderclap headaches are dramatic. Symptoms include pain that:

  • The strikes suddenly and severely
  • The peaks within 60 seconds
  • May be accompanied by nausea or vomiting

Thunderclap headaches may be accompanied by other signs and symptoms, such as:

  • Altered mental status
  • Fever
  • Seizures

These signs and symptoms may reflect the underlying cause.

When to see a doctor

Seek medical attention immediately for any headache that comes on suddenly and severely.

Causes

There is No obvious cause for some thunderclap headaches. In other cases, a variety of life-threatening diseases may be responsible, including:

  • Bleeding between the brain and the membranes covering the brain (subarachnoid hemorrhage)
  • A rupture of a blood vessel in the brain
  • A tear in the inner lining of an artery that supplies blood to the brain
  • The leakage of cerebrospinal fluid, usually due to a tear of the skin around the nerve root in the spine
  • The death of the tissue or bleeding in the pituitary gland
  • A blood clot in the brain
  • Severe elevation of blood pressure (hypertensive crisis)
  • Infection such as meningitis or encephalitis
  • Ischemic stroke

Diagnosis

The following tests are commonly used to try to determine the cause of a thunderclap headache.

  • CTscan of the head. CT scans take X-rays to create the slice-like, cross-sectional images of the brain and the head. A computer combines these images to create a complete image of your brain. Sometimes an iodine-based dye is used to enhance the image.
  • Lumbar puncture (lumbar puncture). The doctor removes a small amount of fluid that surrounds the brain and spinal cord. The sample of cerebrospinal fluid can be tested for signs of bleeding or infection.
  • The magnetic resonance imaging. In some cases, this imaging study could be done for further evaluation. A magnetic field and radio waves are used to create cross-sectional images of the structures inside your brain.
  • The magnetic resonance angiography. Mri machines can be used to determine the flow of blood in the inside of your brain in a test called magnetic resonance angiography (MRA).

Treatment

The treatment is directed at the cause of the headaches — if one can be found.

Preparing for your appointment

Thunderclap headaches are often diagnosed in an emergency room. However, if you call to schedule an appointment with your doctor, you may be referred immediately to a doctor who specializes in the brain and the nervous system (neurologist).

If you have time to prepare for your appointment, here's some information to help you prepare.

What you can do

Make a list of:

  • Your symptoms, including any that may seem unrelated to your headaches, and when they began
  • Key personal information, including major stresses, recent changes in the life and medical history
  • All the drugs, vitamins, and other supplements that you take, including over-dose
  • Questions to ask your doctor

Have a friend or family member, if possible, to help you remember the information that you receive.

Some questions to ask your doctor include:

  • What is likely causing my headache?
  • There are other possible causes of my headaches?
  • What tests do I need?
  • Is my condition likely temporary or chronic?
  • What is the best course of action?
  • I have these other health conditions. How can I best manage them together?
  • There are restrictions that must be followed?
  • You should see a specialist?
  • Are there brochures or other printed material that I can take with me? What sites do you recommend?

Do not hesitate to ask other questions.

What to expect from your doctor

Your doctor may ask you questions, including:

  • Have you had any other thunderclap headaches?
  • Do you have a history of other headaches?
  • If you've had other headaches, have been continuous or occasional?
  • Describe your headache and its symptoms
  • How severe are your headaches?
  • What, if anything, seems to improve your headaches?
  • What, if anything, appears to worsen headaches?
Symptoms and treatment of Thunderclap headaches