This article will review the symptoms, causes, diagnosis, and treatment of a thunderclap headache.
It will also explain why a thunderclap headache is a medical emergency that’s almost always considered dangerous.
The headache is excruciatingly painful and begins abruptly and unexpectedly, like a clap of thunder.
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A thunderclap headache may exist alone or be accompanied by other symptoms, depending on its cause.
Diagnosis of Exclusion
Diagnosis of a primary thunderclap is one of exclusion.
This means an exhaustive approach to rule out secondary causes must be performed first.
Another common cause of a thunderclap headache isreversible cerebral vasoconstriction syndrome(RCVS).
A primary thunderclap headache is treated with anonsteroidal anti-inflammatory drug(NSAID), commonly Indocin (indomethacin).
The treatment of a secondary thunderclap headache involves addressing the underlying cause.
For example, individuals withsubarachnoid hemorrhageare treated in a hospital’sintensive care unit(ICU).
In the ICU, medications are given to control blood pressure and seizure activity.
Blood-thinning medicines like aspirin and Jantoven (warfarin) are also discontinued to help stop bleeding.
A surgical procedure prevents rebleeding if a ruptured aneurysm causes a subarachnoid hemorrhage.
Diagnosing the cause of a thunderclap headache requires prompt medical action.
What Is a CT Scan?
Excess red blood cells in the cerebrospinal fluid support a diagnosis of subarachnoid hemorrhage.
Treatment involves addressing the root cause, often including intensive care, intravenous medications, or surgery.
- A case report and review.Surg Neurol Int.
2014;5:22. doi:10.4103/2152-7806.127756
International Headache Society.Primary thunderclap headache.
Chen CY, Fuh JL.Evaluating thunderclap headache.Curr Opin Neurol.
