Thunderclap headache (TCH) is a term introduced to describe the apoplectic onset of a headache that begins suddenly, without warning and peaks with severe intensity within seconds. A person often describes this headache as “the worst headache of my lifetime.”
Thunderclap headache appears as an extremely painful headache, reaching at least 7 out of 10 in intensity (on a pain scale) within a minute of its onset, and each episode can last for at least five minutes. This headache is typically a symptom of several conditions that have the potential for significant morbidity and mortality.
What is the cause of a thunderclap headache?
Most causes of thunderclap headache result from a problem with the blood vessels around the brain, due to injury or heavy exertion.
Furthermore, the main causes of thunderclap headache include:
- Torn or ruptured brain blood vessels
- Stroke (blocked or bleeding blood vessel)
- A brain aneurysm (bulging or bleeding blood vessel)
- Head injury that causes a brain bleed
- Vasculitis (swollen blood vessel)
- Infections occurring in the brain, such as encephalitis or meningitis
- A sudden severe rise in blood pressure
- Pregnancy complications, including a rise in blood pressure and bleeding in the brain’s pituitary gland during labor
- Spasms in the blood vessels surrounding the brain (vasoconstriction syndrome) or severe vascular migraine
What are the signs and symptoms of a thunderclap headache?
The key symptom of a thunderclap headache is sudden and severe pain in the head. This pain reaches its most intense peak within 60 seconds and lasts for at least five minutes.
Other symptoms of a thunderclap headache may include:
How is thunderclap headache diagnosed?
The tests that are commonly being used to determine the cause of a thunderclap headache include:
- Computed tomography or CT scan of the head. CT scans use X-rays to create slice-like, cross-sectional images of the head and brain. A monitor combines these images to create a full picture of the brain. On some occasions, an iodine-based dye is used to augment the picture.
- Spinal tap (lumbar puncture). The health professional removes a small amount of the fluid surrounding the brain and spinal cord. The cerebrospinal fluid sample can then be tested to verify any signs of bleeding or infection.
- Magnetic resonance imaging or MRI. In some cases, this imaging study is recommended for further assessment. A magnetic field and radio waves are used to capture the cross-sectional images of the structures in the brain. It may show blood vessel lesions.
- Magnetic resonance angiography or MRA. This test may use MRI machines to locate the blood flow inside the brain.
What is the treatment of thunderclap headache?
The treatment option for thunderclap headache is determined based on its cause. Treatments are mainly targeted to treat the cause of the headache, which may include:
- Intravenous or oral nimodipine (a calcium channel blocker) can be administered if the thunderclap headache is caused by spasms in the brain’s blood vessels.
- Medications to control blood pressure.
- Sometimes, surgery may be required to repair torn or ruptured blood vessels or remove a blockage to cure a thunderclap headache.
- Pain medications to manage recurrent thunderclap headache that is associated with a specific trigger.
- Also, managing underlying health conditions and avoiding triggers are the best ways to prevent them from occurring frequently. Maintaining a healthy diet and active lifestyle helps keep blood pressure from rising to levels that could cause a condition, which may precipitate a thunderclap headache.
- Quitting smoking and controlling cholesterol levels help to reduce the risk of blood vessel problems.
QUESTION
The abbreviated term ADHD denotes the condition commonly known as: See AnswerDodick DW. Thunderclap Headache. J Neurol Neurosurg Psychiatry. 2002;72:6-11. https://jnnp.bmj.com/content/72/1/6
Sekhon S, Sharma R, Cascella M. Thunderclap Headache. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 https://www.ncbi.nlm.nih.gov/books/NBK560629/
Linn FH. Primary thunderclap headache. Handb Clin Neurol. 2010;97:473-81. https://pubmed.ncbi.nlm.nih.gov/20816448/
Top How Long Does Headache Last After Thunderclap Related Articles
Does New Daily Persistent Headache Ever Go Away?
New daily persistent headache (NDPH) does not have a specific treatment, however, certain medication, behavioral therapy and stress management may help patients get better.
Headache
Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.
What Gets Rid of Headaches Quickly?
Headaches are a common complaint for many people. There are many types of headaches such as migraine, tension, cluster, and the general run of the mill headache. These 17 natural home remedies -- for example, exercise, meditation, hydration, yoga, caffeine, essential oils such as lavender and butterbur, herbs, and supplements like magnesium -- can soothe and relieve some headaches.
Headaches Quiz
If you're plagued with headaches, our Headaches Quiz may help you identify causes, triggers, symptoms, and treatments for headache pain caused by different types of headaches such as migraines, sinus, cluster, tension, or stress.
Is Having a Chiari Malformation Life-Threatening?
Chiari malformation symptoms include vomiting, muscle weakness in the head and face, difficulty swallowing, varying degrees of mental impairment, headache, neck pain, progressive scoliosis (curvature of the spine), difficulty with balance and coordination, and others. It can be life threatening if it affects the mouth and throat.
Top Self-Care Techniques for Migraine
A migraine can be more than just a whopping headache. Try these self-care tips for relief before and after it hits.
Migraine or Tension Headache? Symptoms, Triggers, Treatments
What does a migraine headache feel like compared to a tension headache? Learn to spot migraine symptoms early, how to identify your triggers, and get more information on migraine headache medications and treatments. Learn to tell migraine from other types of headaches.
Migraine vs. Headache: Differences and Similarities
Headaches are the most common reason why a person goes to the doctor or other healthcare professional for treatment. There are different types of headaches, for example, migraine, tension, and cluster headaches. The most common type of headache is tension headache. Migraine is much less common. There are few similarities between migraine and other headaches, for example, the severity of the pain can be the same, mild, moderate, or severe; and they can occur on one side or both sides of the head. However, there are many differences between migraine and other types of headaches. Migraine headaches also have different names, for example, migraine with aura and menstrual migraine.Symptoms of migraine that usually aren't experienced by a person with another type of headache include nausea, vomiting, worsens with mild exercise, debilitating pain, eye pain, throbbing head pain.
Migraine trigger include light, mild exercise, strong smells, certain foods like red wine, aged cheese, smoked meats, artificial sweeteners, chocolate, alcohol, and dairy products, menstrual period, stress, oversleeping, and changes in barometric pressure.
Untreated migraine attacks usually last from 4 to 72 hours, but may last for weeks. Most headaches resolve within 24-48 hours. Doctors don't know exactly what causes migraine headaches; however, other headaches like tension headaches have more specific triggers and causes. Additional tests usually are required to diagnose migraine from other types of headaches, diseases, or other medical problems. Most headaches can be treated and cured with home remedies like essential oils, massage, and over-the-counter pain medication like acetaminophen (Tylenol) and NSAIDs (nonsteroidal anti-inflammatory drugs) like naproxen (Aleve, Anaprox, Naprosyn) or ibuprofen (Advil, Midol, Motrin). Most headaches resolve with OTC and home remedy treatment, while your doctor may need to prescribe medication to treat your migraines. If you have the "worst headache of your life," seek medical care immediately.
Non-Drug Migraine Help
Learn about 14 non-drug treatments for migraines. Acupuncture, biofeedback and massage therapy are among this list of non-drug migraine treatments that may help ease pain.
Is It Normal to Have Headaches in Second Trimester Pregnancy?
Many women experience headaches during pregnancy. Headaches tend to be worse during the first trimester and they get better in the second and third trimesters although some women still experience headaches during the second trimester.
Tension Headache
A tension headache is one of the most common types of headaches, and the exact cause is not known. Factors that may contribute to tension or stress headaches are lack of sleep, increased stress (referred to as a stress headache), skipping meals, dehydration, medical diseases or conditions, anxiety, or changes at home, work, or school. Treatment of tension headaches include prescription and OTC medications, stress management, and treating any underlying illness or condition.
What Are the Causes of a Headache Behind the Eyes?
A headache behind the eyes is an uncomfortable sensation that is felt around or on the back of the eye, which may or may not be a throbbing ache. Causes of headaches behind the eyes include tension headaches, migraines, cluster headaches, sinus headaches, occipital neuralgia, brain aneurysm, Grave's disease, scleritis, dry eyes, vision problems, eye strain and poor posture.
What Causes Headaches at the Back of the Head?
Headaches in the back of the head can have a number of different causes; it might only be due to a minor injury or it can be a secondary symptom of other problems in the body. The type and location of the pain can play a crucial role in diagnosing the cause of headaches.
What Does a Pseudotumor Cerebri Headache Feel Like?
Pseudotumor cerebri headaches usually feel like a headache that occurs at the back of the head or behind the eyes. The pain starts as a dull, aching pain that worsens at night or in the morning. They may be associated with vomiting as well. Patients may also eventually develop visual problems and blindness due to inflammation of the optic nerve.