Thunderclap headaches

Overview

Thunderclap headaches live up to their name, striking suddenly like a clap of thunder. The pain of these severe headaches peaks within 60 seconds.

Thunderclap headaches are uncommon, but they can warn of potentially life-threatening conditions — usually having to do with bleeding in and around the brain. Seek emergency medical attention for a thunderclap headache.

Symptoms

Thunderclap headaches are dramatic. Symptoms include pain that:

• Strikes suddenly and severely
• Peaks within 60 seconds
• Can be accompanied by nausea or vomiting

Thunderclap headaches might be accompanied by other signs and symptoms, such as:

• Altered mental state
• Fever
• Seizures

These signs and symptoms might reflect the underlying cause.

When to see a doctor

Seek immediate medical attention for any headache that comes on suddenly and severely.

Causes

There's no obvious cause for some thunderclap headaches. In other cases, a variety of potentially life-threatening conditions might be responsible, including:

• Bleeding between the brain and membranes covering the brain (subarachnoid hemorrhage)
• A rupture of a blood vessel in the brain
• A tear in the lining of an artery that supplies blood to the brain
• Leaking of cerebrospinal fluid — usually due to a tear of the covering around a nerve root in the spine
• Death of tissue or bleeding in the pituitary gland
• A blood clot in the brain
• Severe elevation in blood pressure (hypertensive crisis)
• Infection such as meningitis or encephalitis
• Ischemic stroke