Thunderclap headaches are severe headaches that occur suddenly. There is no gradual increase in intensity with this type of headache pain. Rather, when it starts, it’s an extremely painful headache that’s immediately intense. It’s sometimes called the worst headache of a person’s life.
Thunderclap headaches may indicate a potentially life-threatening condition. If you think you’re experiencing one, you should seek medical attention immediately. However, a doctor should still check it right away to determine what’s causing it, since it may have a benign cause that is not life-threatening.
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Thunderclap headaches symptoms
Thunderclap headache symptoms are similar regardless of what causes them. The following symptoms may occur:
- An unbearable headache that seems to appear out of nowhere
- Nausea and vomiting
- A headache that feels worse than any other
- Anywhere in the head hurts
- Even your neck hurts when you have a headache
Certain activities may trigger it, or there may be no trigger at all.
Thunderclap headaches tend to peak between 30 and 60 seconds after onset. There are many times during which the pain will start to fade about an hour after the worst part, but sometimes it might last for a week.
Postcoital thunderclap headache
Thunderclap headaches, sometimes called orgasm headaches, are headaches caused by sexual activity.
This might be due to the dilation of the blood vessels due to the increased blood pressure that occurs during an orgasm. An increase in arousal can also lead to contractions of the muscles in your head and neck, which can result in headaches.
An orgasm can sometimes occur suddenly, often with a pounding headache preceding it. Additionally, you might experience a dull ache in your head or neck, which becomes stronger as you get more excited. Thunderclap headaches can be mild or very severe, lasting between one minute and 72 hours.
People with a history of migraine and men may be at a higher risk of postcoital thunderclap headaches, although anyone can be affected.
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Causes and triggers
Thunderclap headaches are frequently caused by subarachnoid hemorrhage, which can cause life-threatening bleeding in the brain if not treated. Bleeding due to a ruptured aneurysm in the brain is the most common cause.
Other severe and potentially life-threatening causes include:
- An injured, blocked, or ruptured blood vessel in the brain
- Hemorrhagic stroke
- Ischemic stroke
- Head injury of mild to moderate severity
- Reversible cerebral vasoconstriction syndrome.
- Vessel inflammation, or vasculitis
Thunderclap headaches may not have an identifiable physical cause. A benign, recurrent condition known as idiopathic thunderclap headaches causes these types of headaches.
There are no other causes of these types of headaches. Some things may trigger this type of panic, even though it may not be a cause. Here are some triggers:
- Sexual activity
- Physical activity
- Straining during bowel movements
Thunderclap headache vs. migraine
Thunderclap headaches aren’t typically migraines. Most people who suffer from thunderclap headaches, however, have also experienced migraines in the past.
It can only be determined which type of headache you have by a medical professional. A thunderclap headache may be a migraine type of disorder if tests do not reveal a life-threatening cause.
Thunderclap headache treatment
It is important to identify the cause of thunderclap headaches before treating them. A CT scan is typically conducted after your doctor has examined you and collected information about your symptoms. In many cases, your doctor will be able to determine the cause of your symptoms based on a CT scan.
However, if no clear cause is found, you’ll need to run additional tests.
The following tests should be performed:
- Magnetic resonance imaging (MRI): Your doctor can see how your brain is structured through an MRI.
- Magnetic resonance angiography (MRA): Through the use of an MRI machine, you can map the blood flow in your brain.
- Lumbar puncture: The lumbar puncture procedure, also known as a spinal tap, is used to obtain blood or fluid samples from your spinal cord; the samples are then tested. These fluids are similar to those surrounding your brain.
Thunderclap headaches can be treated in several ways depending on their cause. These treatments treat the underlying cause. Examples of treatments are:
- Repairing a tear or blocking a vein
- Controlling blood pressure with medication
- Pain medications for dealing with recurring thunderclap headaches, particularly those triggered by a particular trigger
A thunderclap headache isn’t completely treatable with these options. If you have headaches for a specific reason, your doctor will advise you about the best treatment for you.
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There are several causes of thunderclap headaches, and the cause will determine whether or not it can be reduced. Thunderclap headache can be reduced by reducing the risk of underlying conditions such as:
- Eating a healthy diet
- Regular exercise
- Staying in shape
- Controlling conditions such as hypertension and heart disease
- Quitting smoking
- Limiting alcohol consumption
Complications and related conditions
Many thunderclap headache causes can be life threatening if not identified and treated promptly. Thunderclap headaches can sometimes be caused by:
- Head injury
- High blood pressure
How it differs from other headaches
Thunderclap headaches are similar in severity to the following kinds of headaches. They are usually less severe than thunderclap headaches:
- Ice pick headaches: An acute headache that involves stabbing pains at the front or side of the head.
- Migraines: A severe headache on one side of the head that is severe, throbbing, or pulsating. The symptoms can occur in conjunction with nausea or vomiting.
- Cluster headaches: Headaches that occur rapidly and typically affect the face or front of the head. They usually cause the affected eye to water. The onset of thunderclap headaches is usually rapid.
When to seek medical attention
Any kind of severe and sudden headache should be treated immediately by a medical professional. There may be a life-threatening condition behind this type of headache.
It may not be a life-threatening condition if you get a thunderclap headache. The cause of your headache can only be determined by a medical professional.
Thunderclap headaches can generally be treated or managed effectively if you seek medical attention right away when you experience them. Failure to seek treatment right away might be fatal.
Even if you regularly suffer from migraines, you should still seek medical attention if you develop a sudden and severe headache worse than any other migraine episode you have had in the past.
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The bottom line
Symptoms of a thunderclap headache include severe head pain that occurs suddenly. If you experience a headache, it could be a sign of something more serious, such as bleeding blood vessels in the brain.
It is possible for other symptoms to be present or absent depending on the cause of the thunderclap headache. In addition to weakness and sensory disturbances, confusion can also be indicative of a potentially serious cause.
Patients who experience thunderclap headaches should seek medical attention right away. Emergency treatment may be required depending on the cause.