Thunderclap Headache

What is Thunderclap Headache?

Thunderclap Headache refers to the sudden severe pain on your head and neck that can be rapidly progressive shifting your full attention. This kind of headache is unexpected and its time scale to maximum intensity is very short, usually seconds to minutes.

Its occurrence can be likened to that of natural disasters such as earthquakes, which are categorized as rapid onset (they strike without any warning signs within a very short time).

In most cases, the pain associated with thunderclap headache may last for some days or just live for a couple of hours before it goes away.

Thunderclap Headache

The headache can have detrimental effects on your health, or as well, be a gateway to suspecting possible health issues that need to be addressed. It is therefore important to pay attention and make an appointment with a doctor for examination.


Thunderclap headache can be as a result of physical factors such as:

  • Continued use of hard drugs
  • Engaging in hard tasks that strain your body and work up your brain
  • Habitual use of hot or warm water. This mostly happens to those who turn on the knob for the hot shower very fast without being mindful of the sudden change in temperature when the water lands on the body.

It is not obvious that the reason you have such kind of headache is due to physical activity such as working in the farm the whole day without break; it could be as a result of risky health conditions that can threaten your life. This headache can arise if:

  • Blood leaks from the arteries into the space between the brain and its membranes (subarachnoid hemorrhage)
  • Blood vessels bulge or swell abnormally causing aneurysm
  • Carotid or vertebral arteries that supply the brain with blood have developed small tears in their lining
  • Spinal nerves have tears giving room for the cerebrospinal fluid to leak
  • The flow of spinal fluid stops due to tumor blockage
  • A shortage of blood supply occurs in the pituitary glands
  • There is clotted blood in the brain, which may result in blocked veins
  • Changes in blood pressure are rapid and severely elevated
  • You suffer from meningitis and encephalitis, which contribute to brain infection.

Signs and Symptoms

Although a persistent and severe headache is the overall symptom, there are other symptoms that may be observed:

  • Low levels of consciousness may occur and especially if the headache is due to a tear in the arteries that alters blood flow it the brain. Patients will therefore seem confused and their mind can’t pick things fast as they lack full concentration.
  • Nausea and vomiting may be due to subarachnoid hemorrhage
  • Numbness or tingling, which is the same as to lose a sense of feeling either on part of head or face, especially when the pain has matured
  • General body weakness
  • Stiffness and pain in the neck may be as a result of meningitis
  • Seizures may occur if there is a problem with blood flowing to the brain
  • Visual acuity or sharpness of vision is also a common sign as patients may not see properly and their eyes may be sensitive to light.

Is it a Thunderclap or a Migraine Headache?

It is very common to perceive an ailment and even begin treatment even without prescription. People who suffer from a thunderclap headache may have had a migraine before and may not know when it has eventually crashed resulting to thunderclap.

It is therefore advised that proper examination is done to distinguish between the two for proper treatment.The major characteristic that differentiates thunderclaps from migraines is that they are rapid on onset.

Migraines can be very severe and have similar symptoms. Migraines usually inflict pain on one side of the head and they are said to occur when blood vessels of the neck and head expand and dilate.

Women are the common victims. To understand what actually is the reason for that severe headache, it is good to check for symptoms to note the difference before commencing treatment. The following symptoms can be observed for migraines:

  • A sharp piercing pain on one side of head accompanied with throbbing
  • People with migraine may feel dizzy
  • Nausea and vomiting is very common and may include diarrhea
  • Patients with migraines become sensitive to light and any form of sound
  • Their vision may be impaired in severe cases and even change how they view different objects’ appearance and size
  • Increased anxiety.


When the headache persists and you decide to visit a medic, various tests may be performed to evaluate possible underlying causes. These tests include:

Computerized Tomography (CT) scan

This is usually the first step during diagnosis where X-rays are used to create images of the cross- sectional part of the head and brain. These images are then augmented using a dye (mostly iodine-based) before they are combined using a computer.

People with symptoms such as seizures, nausea and vomiting, reduced consciousness, nuchal rigidity and diplopia are likely to have a positive result in the scan, which therefore calls for more tests.

Lumbar puncture (spinal tap)

This test involves an examination of the cerebrospinal fluid to check for any signs of subarachnoid hemorrhage. However, it is rare to have patients who have gone to this extent.

Whether the results turn out positive or negative, the doctor can make conclusions on the same depending on the history and symptoms of the patient.

Magnetic resonance imaging (MRI)

It is also performed to check for further bleeding in the arteries and in the pituitary glands. Images of brain structures are created by radio waves and magnetic fields to increase accuracy during examination.

Magnetic resonance angiography

This is done in order for the doctor to have a deeper look into the brain when checking on its blood flow using MRI tools. With this imaging test, it is easier to tell of an infection in the brain or traces of blood clots.


Since the causes leading to its occurrence are many and different, there is no specific treatment of the same. However, they can be managed through the following:

  • For the first time it strikes, you can try relieve the pain using a cloth dipped in hot warm water to massage the area before seeking medical attention
  • In most cases, a severe headache can be followed by jaw and neck pains. It is therefore recommended that you relax these areas to ease the pain.
  • Drug abuse and taking other drinks with nicotine and caffeine can be a reason for the sharp headache. Taking lesser amounts of the same can help reduce the painful headaches.
  • Painkillers such as acetaminophen and ibuprofencan relief the pain for a while before visiting a doctor for further checkup
  • For some cases, drugs used for high blood pressure can be recommended for the headache such as calcium-channel blockers
  • Some drugs used to treat or prevent such headaches can have their own impacts on blood vessels and arteries. It therefore good to take the physicians’ prescriptions and not take someone else’s medication. For instance, people suffering from arteriosclerosis, high blood pressure, angina or coronary disease, circulatory problems, severe infections and kidney or liver disorder should open up to their doctors before they start any medication.
  • Asthmatic patients and those with heart disease should not use prophylactic drugs to treat headaches as they impair vessel dilation
  • Patients are also advised to go for neurological therapies
  • It is also important for patients to take note of their progress since the headache started. This is crucial, especially during diagnosis and treatment.

What is the Right Time to Visit a Doctor?

With such kind of headaches, do not hesitate to visit your doctor as ignoring serious symptoms may endanger your life. It is hence advisable to rush for medical assistance if you observe the following:

  • When the headache has failed to go away even after home treatment
  • If you experience a sudden and sharp headache in the middle of the night or very early in the morning
  • If it happens consecutively for 3 to 5 days with the same severity
  • Experiencing a headache after every activity you indulge in such as physical exertion, sex, coughing, or sneezing.

Reference List

  1. Thunderclap headaches: Warning Signs and Treatment-WebMD. Retrieved from
  3. Thunderclap headaches- Mayo Clinic. Retrieved from
  5. Thunderclap Headache-Wikipedia. Retrieved from
  7. Tension Headaches, Migraine Headaches (vascular headaches). Retrieved from
  9. Thunderclap headache- Mayo Clinic. Retrieved from
  11. Thunderclap Headache with Normal CT and Lumbar Puncture. Retrieved from

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