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Thunderclap Headaches | Causes, Symptoms, Treatment

Under: General Health, Migraine & Headache

A thunderclap headache is a severe headache that, as suggested by the name, strikes suddenly, like a clap of thunder. It typically reaches its peak severity within one minute of the onset and fades gradually over the next few hours. Thunderclap headaches are considered a medical emergency because they act as a warning sign for serious medical conditions.

Do I have a thunderclap headache or a migraine?

The most noticeable difference between migraine and thunderclap headaches is the intensity of the pain they produce. Migraine attacks are notorious for being very painful, but those who have experienced a thunderclap headache have called it the worst headache of their lives. This is true even for chronic migraine sufferers.

Unlike migraines, thunderclap headaches are associated with a host of conditions ranging from benign to potentially fatal. The most common are vascular disorders in the brain. One frequent cause of thunderclap headaches is called a subarachnoid hemorrhage, which is bleeding in the membranes around the brain caused by small ruptures in the arteries of the head or neck. Other potentially life-threatening causes include:

Ischemic or hemorrhagic stroke
Hypertensive crisis (severe elevation of blood pressure)
Head injury
Infections such as meningitis or encephalitis
A blood clot in the brain
A ruptured blood vessel in the brain

How are symptoms different between thunderclap headaches and migraines?

thunderclap headache

What’s the difference between thunderclap headache and migraine?


1. There are a few main differences between thunderclap headache and migraine but because thunderclap is really rare and is similar to many other types of head pain causes, it is not often diagnosed.

The biggest difference is in time duration.

2. A migraine may come on slowly, with prodromal symptoms, and aural symptoms long before the head pain. These symptoms may include;

Sensitivity to light
Loss of concentration
Increased urination, etc.

The head pain will also come on slowly and last between 4-72 hours. But a thunderclap headache is very sudden and severe with no warning. It rises to its peak pain within 60 seconds and can last from a few minutes to hours.

3. Migraines can be incredibly severe and crippling but a thunderclap headache is regarded as the worst headache you’ve ever had in your life.

What are the symptoms of a thunderclap headache?


thunderclap headache

Confusion can be a symptom of a thunderclap headache


Regardless of the cause, the most common symptom of thunderclap headaches is sudden and severe pain in the head. This pain usually peaks within the first 60 seconds of the headache starting and lasts at least five minutes. It can be felt anywhere on the head or neck.

There may be other signs and symptoms associated with thunderclap headaches, including:

Nausea and vomiting
Changes in vision or temporary vision loss
Difficulty speaking and thinking

How is a thunderclap headache diagnosed and treated?

Thunderclap headaches are usually diagnosed in the emergency department through a combination of medical history questions and imaging tests. In some cases, a spinal tap may be needed. Because thunderclap headaches tend to be a symptom of a secondary condition, all efforts should be aimed at identifying and treating the underlying problem.

Sometimes it may not be possible to find what’s causing the thunderclap headache. In those cases, the thunderclap headache is considered primary, meaning that it is not the result of any other medical condition. Primary thunderclap headaches are more common in younger adults and may be triggered by coughing, working out, or sexual activity.

Although not all thunderclap headache episodes are life-threatening, it is crucial to seek medical attention right away if you experience a severe and sudden headache of any kind. A thunderclap headache, if not detected early, can lead to severe and potentially lethal complications.

Can thunderclap headaches be prevented?

The sudden onset of thunderclap headaches makes preventing them hard. However, the best way to reduce the risk of developing one is to manage any underlying condition, especially vascular and blood pressure problems. Some easy lifestyle changes you can make to control your blood pressure include:

Losing weight
Eating a healthy diet
Exercising regularly
Limiting alcohol
Avoiding cigarette smoke
Managing stress