From Wikipedia, the free encyclopedia

A thunderclap headache is a headache that is severe and sudden (like a thunderclap).^[1] Because it may be a sign of a medical emergency, some sources recommend immediate medical attention.^[1]

In 25% of cases, a thunderclap headache is an indication of aneurysmal subarachnoid hemorrhage (SAH), which often leads to death or severe disability.^[2] Headaches which accompany SAH are "frequently described as being the worst headache of one's life, although other clinical presentations are possible."^[3]

Diagnosis is made via a process of exclusion with accompanying negative computed tomograph and lumbar puncture results.

Causes

Thunderclap headaches can be caused by a number of different primary conditions including^[4][5]

• Subarachnoid hemorrhage
• Cerebral venous thrombosis
• Cervical artery dissection
• Pituitary apoplexy
• Ischemic stroke
• Orgasm
• Acute hypertensive crisis
• Colloid cyst of the third ventricle
• Meningitis
• Reversible cerebral vasoconstriction syndromes or RCVS (this includes hypertensive encephalopathy and vasculopathies associated with pregnancy and postpartum (postpartum angiopathy))
• Primary thunderclap headache
• Complicated sinusitis^[6]

References