A very intense headache with a sudden onset is often referred to as thunderclap headache. Such a painful episode reaches a maximum within seconds or minutes, and it can indicate a very serious and even life-threatening medical condition: subarachnoid hemorrhage. Venous sinus thrombosis and cervical artery dissection are the other two main conditions responsible for the symptom.
More symptoms associated with a thunderclap pain include seizures, neck stiffness and pain, vomiting, loss of consciousness and lots of other psycho-somatic problems. Such neurological abnormalities accompany bleeding at the brain level or severe hypertension.
There are however some rare cases when a thunderclap headache is not caused by a specific medical problem, but rather by environmental factors. Finding the underlying cause may prove an impossible task. Yet, you should not wait for the pain to go away or use pain killers to make it stop as you might have a ticking bomb inside your head. There’s no time to waste!
Other possible causes for thunderclap headache
- Very high blood pressure
- Spontaneous intracranial hypotension
- Hematoma at the head level caused by physical injury
- Infection of the pituitary glad or hemorrhage in the pituitary gland
- Primary coughing symptoms
- Stroke
The cause can be identified through computed tomography or CT. The doctor will most certainly look for an aneurism. If the CT does not reveal any abnormality at the head level a lumbar puncture is performed for white blood and protein count. If none of these tests help to diagnosis, magnetic resonance imaging, magnetic resonance venography and magnetic resonance angiography will be performed to search for possible dissections in the arteries or venous thrombosis.
Sometimes a tear occurs in the blood vessels or around the spinal cord and only through specialized scanning can the health problem receive proper diagnosis.
Cerebral angiography is performed only if the other tests don’t reveal the problem. It is more invasive, therefore doctors use it only if it’s an absolute must. A thunderclap headache episode is taken very seriously and requires emergency medical attention. Do not hesitate to seek help right away for yourself or for a dear one.
The treatment very much depends on the underlying cause of the problem. It often involves a surgical intervention combined with the administration of oral medication. Without an underlying cause, no treatment can be prescribed.
The pros and cons of surgical treatments
Many people who experience thunderclap headache are faced with the tough decision of undergoing brain surgery or risk to die. It’s indeed a tough decision because the risks of having the surgery are just as serious: memory loss, disturbance of cognitive functions, coma and even death.
When the condition of the patient is too severe and he/she cannot decide for himself/herself, the family has to make a decision for the treatment. It is preferable to follow the doctor’s recommendations and choose the course of action that has the most numerous benefits as compared to the risks.
Without medical test exams it is not possible to treat thunderclap headache at home.