Thunderclap Headache Symptoms, Causes, And Treatment

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Thunderclap Headache Symptoms, Causes, And Treatment

What Is A Thunderclap Headache?

As the name suggests, thunderclap headache symptoms feel like a “thunderclap”. A thunderclap headache is a sudden and striking type of headache, like a “clap of thunder”, that typically peaks within 60 seconds. Even though thunderclap headaches are rare, they can be potentially life-threatening.

What Does A Thunderclap Headache Feel like?

A thunderclap headache is notoriously known to be one of the most painful headaches. The pain often peaks at the onset of the thunderclap headache. Most people usually describe a thunderclap headache as the “most painful headache they have in their life”.

Thunderclap Headache Symptoms


Thunderclap headache symptoms can be quite dramatic. Here are some common thunder headache symptoms:

  • Nausea and vomiting
  • Sudden, severely painful headaches, with the pain peaking within 60 seconds
  • Fever
  • Seizures
  • Delirium

Thunderclap headaches are severely painful, with the pain noted to last for around 5 minutes. Thunderclap headache symptoms usually fade away after a few hours.

Thunderclap Headache Causes

The causes for most thunderclap headaches can be attributed to bleeding in or around the brain. However, this would be considered a more severe thunderclap headache. Other potential thunderclap headache causes include an ischemic stroke. Here are some potential thunderclap headache causes:

  • Blood clot in the brain
  • A tear in the lining of an artery supplying blood to the brain
  • Bleeding occurs within or around the brain (also known as a subarachnoid hemorrhage)
  • Rupturing of a blood vessel in the brain
  • Severe elevation in blood pressure
  • Leaking of cerebrospinal fluid
  • Death of tissue or bleeding within the pituitary gland
  • Infection, such as meningitis or encephalitis.

Sometimes, thunderclap headaches might be a warning sign of an ischemic stroke (IS). Ischemic stroke is a type of stroke that occurs when the blood supply to the brain is disrupted or reduced.

Thunderclap Headaches VS Ice Pick Headaches

The difference between thunderclap headaches and ice pick headaches is that the pain of an ice pick headache is akin to a “stabbing” sensation behind the eyes. The pain of ice pick headaches usually last only for a few seconds while thunderclap headaches can last longer than that.

Also, ice pick headaches often strike in quick succession, in “clusters” or “bursts of pain”. However, the pain of thunderclap headaches are often sustained.

Also, another difference between thunderclap headache vs ice pick headaches is that ice pick headaches are usually more common with people who suffer from migraine.

Thunderclap Headaches After Exercise

Idiopathic thunderclap headaches may strike suddenly due to strenuous exercise, or exertion. Thunderclap headaches may occur again over a 7–14 day time frame. This explains why you may experience thunderclap headaches after exercise.

Thunderclap headaches during, or after sexual activity may happen. You may find yourself experience thunderclap headache after orgasm or climax. This is also known as post coital thunderclap headache. These headaches can last for hours. Often, there may not necessarily be an underlying medical condition that cause the thunderclap headache after sex.

Thunderclap Headache Diagnosis

There are a couple different ways that a thunderclap headache is diagnosed, which
include a CT scan of the head, and a spinal tap (lumbar puncture). Further testing may be needed,
and the test conducted is usually Magnetic Resonance Imaging (MRI). During the MRI, providers can also perform a test called magnetic resonance angiography, which is a test that can be used to map the blood flow inside of the brain. The type of thunderclap headache treatment is dependent on the thunderclap headache cause.


Preparing for the appointments associated with getting a diagnosis of thunderclap
headaches is important since these headaches are typically associated with life-threatening
emergencies. Whereas most thunderclap headaches are diagnosed within an emergency room,
some are diagnosed by a neurologist. Doctors are going to ask questions about any previous
headaches and previous symptoms and what things, such as medication or non-medicinal
treatments, have been tried to help. Patients should bring a trustworthy person to the appointment
with them; patients can also bring a list of questions regarding headaches and if a diagnosis is
made, patients may have follow-up questions. Patients should bring a list of symptoms, key
information that could be related to the headaches, such as significant stressors or other health
conditions that could cause headaches and a list of current medications.

(The above article is contributed by Rachel Sparrow, one of our amazing #MBvolunteers)

Jenny from Migraine Buddy
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