A thunderclap headache occurs abruptly that is characterized by intense pain that reaches its peak intensity in a minute. After an hour or so, the headache starts to settle. In some cases, the headache might even last for more than a week.
This type of headache is considered rare but if it occurs, it might be an indication of a life-threatening medical condition such as internal bleeding present in different parts of the body or the brain. Immediate medical attention is vital for this type of headache.
What are the causes?
A thunderclap headache can arise without any evident cause. Nevertheless, they can be triggered by potentially life-threatening conditions such as:
- Internal bleeding in the brain and inside the membranes covering the brain
- Broken blood vessel in the brain
- Stroke
- Blood clot in the brain
- Certain types of infections such as meningitis or encephalitis
- Any tear in the arteries that supply blood to the brain
- Excessively high blood pressure (hypertensive emergency)
- Any tear in the covering of the spinal nerve root which leads to the leakage of the cerebrospinal fluid
- Bleeding within the pituitary gland internally or necrosis
- Tumor in the 3rd ventricle of the brain that disrupts with the course of the cerebrospinal fluid
Indications of a thunderclap headache
- Abrupt and extremely intense headache
- The headache rapidly worsens and reaches its peak intensity in a minute
- The discomfort can last for up to an hour or up to 10 days
- The pain can occur in the head or in the neck area
- Nausea or vomiting
- Weakness or visual impairment
- If there is subarachnoid hemorrhage, the individual might lose consciousness and even end up with a seizure, neck pain and stiffness, vomiting and visual disturbances
Management
The treatment for a thunderclap headache is based on the underlying cause. Since there are various causes, it is vital to come up with a correct diagnosis so that proper treatment can be started.
The treatment might include prescription medications, lumbar puncture and even surgery in severe cases. If the individual is vomiting, intravenous pain medications are given.
Surgical intervention is necessary if there is a blood clot present. In case the cause of the thunderclap headache is meningitis, the treatment involves antibiotics.