What Are the Causes of Thunderclap?

Thunderclap headaches are characterized by a sudden and severe headache with intense pain which peaks within 60-seconds and typically lasts for one hour but can also last for more than one week. As these uncommon headaches may be a sign of a serious medical condition, it is important to seek immediate medical attention in the event of a thunderclap headache.

Symptoms

• The symptoms of thunderclap headaches are generally easy to recognize. The headache strikes suddenly, much like a thunderclap, and occurs with severe pain often described as similar to a kick to the back of a head or as the worst headache a person has ever experienced. Thunderclap headaches occur anywhere in the neck or head and may encourage vomiting or nausea.

Causes

• In some cases, a thunderclap headache occurs for no identifiable physical reason; however, in some instances, these headaches are signs of potentially life-threatening medical conditions. Medical conditions which cause thunderclap headaches include severely high blood pressure, a blood vessel rupture in the brain, a blood clot in the brain, infections such as encephalitis or meningitis, cerebrospinal fluid leakage, a brain tumor, bleeding in the brain or a tear in an lining of an artery such as a vertebral or carotid artery.

Testing and Diagnosis

• A doctor will use a series of tests to diagnosis any underlying conditions causing thunderclap headaches. Computed tomography uses x-ray scans of the head and brain and combines the pictures together to create a full picture of the brain. During spinal taps, or lumbar punctures, doctors remove a small amount of the cerebrospinal fluid surrounding a person's spinal cord and brain to test for signs of infection or bleeding. Sometimes, doctors will use magnetic resonance imaging to study images of the brain or MR angiography to map the blood flow inside the brain.

Treatment

• Treatment of thunderclap headaches is dependent on a doctor's diagnosis of an underlying condition causing the headaches. If an underlying condition is causing the thunderclap headaches, a doctor will focus on treating the underlying problem, which will result in the control or elimination of thunderclap headaches. If the doctor finds no underlying conditions, no treatments are available to control or eliminate thunderclap headaches.