Not all headaches are the same, and each type of headache has its own name and set of symptoms. A sudden onset, very painful headache is called a thunderclap headache (TCH.) This type of headache is different from the more common and well-known headaches, like a migraine or a tension headache: while they are uncommon, a TCH is a medical emergency.
If you believe you are experiencing this type of headache, you should call 911 or go to the emergency room as soon as possible.
Causes
According to the Mayo Clinic and Harvard Health, TCHs have a variety of potential causes. These causes can include:
- Bleeding between the brain
- A rupture of blood vessels in the brain
- A tear in the lining of an artery
- A blood clot in the brain
- Severe elevation in blood pressure (hypertensive crisis)
- Infection such as meningitis or encephalitis
- Ischemic stroke
Signs
According to the Mayo Clinic, signs of TCHs could include pain that:
- Strikes suddenly and severely
- Peaks within 60 seconds
- Can be accompanied by nausea or vomiting
TCHs may be accompanied by other signs such as:
- Altered mental state
- Fever
- Seizures
Primary and Secondary TCHs
There are primary and secondary TCHs. A secondary TCH has an underlying cause. For example, neck stiffness or lack of sleep could be an indicator of a ruptured brain aneurysm or infection. Even if other signs are absent, these causes cannot be ruled out, which is why computed tomography (CT) or magnetic resonance imaging (MRI) may be needed.
If a secondary cause is found, then the underlying problem will be treated. If no obvious cause is found, the TCH is considered “primary.” These types of TCHs primarily affect young adults, and are associated with physical triggers such as a cough or exercise. It is rare that people develop multiple and reoccurring TCHs within the time frame of a couple of days.
There is no known prevention for a primary TCH. However, for those who are experiencing one, bed rest is recommended. Exercise, anxiety and sexual activity can aggravate the TCH. Laxatives and stool softeners are also recommended to avoid constipation, since straining or bearing down can trigger a TCH.
Common pain relievers such as Tylenol and Advil may help, however, drugs such as morphine and other opioids may be prescribed for prolonged or very severe head pain.
While primary TCHs can recur intermittently for several years, most people can resume their normal routines and activities after the sudden-onset headaches subside.
For more information, visit www.HarvardHealth.com.
