Thunderclap Headache - The Worst Possible Headache?

A thunderclap is like the worst headache that anyone ever has to experience. This type of headache doesn’t gradually build into such severe pain but starts off as very intense and painful. It can be a terrifying experience for anyone and urgently seeks medical attention as it could be a symptom of a life-threatening condition. 

They can be divided into two broad groups - those caused by vascular or blood vessel problems, injury, or uncommon structural problems in the brain, and those that have no clear cause and are not considered dangerous. The causes of Thunderclap headache may include:

  • Rupture of blood vessels in the brain
  • Death of tissue or bleeding in the pituitary gland
  • Blood clot in the brain
  • Ischemic stroke
  • Hemorrhagic stroke
  • Blocked or bleeding blood vessels
  • Swollen blood vessels

Symptoms of a thunderclap headache: 

The main symptom is the severe pain in the head which can last at least five minutes. Other symptoms may include: 

  • Numbness
  • Nausea and vomiting
  • Seizures
  • Vision changes
  • Confusion
  • Change in sensation
  • Speech problems

Diagnosing the cause & Treatment 

While experiencing a severe and sudden headache, the best choice to make is to consult a doctor as this type of headache could be a sign of a life-threatening condition. It’s not necessarily a life-threatening disease but medical assistance can determine the cause and effects of the condition through diagnosis and proceed to treatment if required. Initially, the goal is to determine the cause of the headache. After matching the symptoms and physical evaluation, generally, a CT scan is preferred by the doctors to figure out the actual cause of the situation. 

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In case, CT scan does not produce the desired results, some other tests are performed such as:

  • MRI (Magnetic Resonance Imaging): It uses a magnetic field and radio waves to create cross-sectional images to see the structures of the brain.
  • MRA (Magnetic Resonance Angiography): It is used to map the blood flow in the brain using an MRI machine.  
  • Lumbar Puncture (Spinal tap): In this, a sample of blood or fluid is removed from the spinal cord for testing. This is the same fluid that is surrounding the brain and is tested for signs of bleeding or infection. 

The treatment for this condition completely depends on what’s causing the headache. The thunderclap headache treatment is mainly focused on the cause, which includes:

  • Surgery, in case of tear or blockage of any blood vessel
  • Medication, if the cause is high/low blood pressure  
  • Pain medication, for recurrent headaches due to a specific trigger 

Thunderclap headache vs. Migraine 

Both migraine and thunderclap headaches aren’t easy to go through as the pain is generally too extreme to resist, bt they are still not the same conditions. The main difference between the two is the severity of the pain. Thunderclap headaches are considered the worst kind of headaches in terms of pain and it could just be the worst pain you’ve ever experienced.

The type of headache is usually revealed through medical tests. If tests reveal that the thunderclap headache does not have any life-threatening symptoms, then it may also be considered a type of migraine headache. 

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