Thunderclap headache, also known as “thunderclap headache” in English, is a headache of the most severe, previously unknown intensity. It starts suddenly and reaches its pain maximum within one minute. Subsequently, it can last from one hour to ten days. Accompanying symptoms such as nausea, vomiting or sensitivity to light may occur. Since a life-threatening brain hemorrhage could be the cause, a doctor should be consulted immediately whenever a thunderclap headache develops.
Primary and secondary thunderclap headache.
Thunderclap headache is divided into a primary and a secondary form:
- Primary or idiopathic thunderclap headache is also called annihilation headache. It has no organically identifiable cause and is considered “benign”.
- In a secondary or symptomatic form, on the other hand, the headache is based on a disease. Despite different causes, the symptoms that occur are the same in both cases.
Primary thunderclap headaches occur in less than 0.05 percent of the population. Reportedly, the pain occurs predominantly in the age group between 25 and 65 years. They are said to be particularly common in patients with a history of migraine.
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Thunderclap headache as a symptom of other conditions
It is controversial among medical experts whether thunderclap headache even exists as an independent primary headache form. Therefore, a careful search should always be made for a possible cause of the complaints. This is because the headache often occurs as a leading symptom of serious disorders of the blood vessels within the skull.
Consequently, the diagnosis of a primary thunderclap headache should not be considered certain until all other possible causes have been ruled out.
Cerebral hemorrhage as the most common cause
The most common and also most dangerous cause of secondary thunderclap headache is a specific form of brain hemorrhage called subarachnoid hemorrhage (SAB). In 20 to 50 percent of all sufferers, it is preceded by a thunderclap headache as a warning symptom.
A subarachnoid hemorrhage is bleeding in the gap between the middle meninges and the surface of the brain. Many blood vessels run in this narrow space. If a vessel ruptures (rupture), the escaping blood spreads in the subarachnoid space and presses on the brain from the outside. The cause of cerebral hemorrhage is usually dilatation of arteries (aneurysms) at the base of the skull.
Subarachnoid hemorrhage can usually be identified by computed tomography as a flat, white area adjacent to the surface of the brain. In the worst case, it can cause a stroke and lead to severe, permanent brain dysfunction. Because SAB is life-threatening, prompt intensive medical treatment is essential.
Other causes of thunderclap headache
Other possible causes of thunderclap headache may include:
- A sinus vein thrombosis
- A meningitis
- A sinusitis (inflammation of the sinuses)
Thunderclap headache: immediately to the doctor!
Any sudden onset, massive thunderclap headache can potentially be very dangerous. To rule out a life-threatening brain hemorrhage or other organic cause, you should go to a hospital emergency room as soon as possible and undergo a thorough diagnostic evaluation.
