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Thunderclap Headache

  • Headache (R Halker, Section Editor)
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Abstract

Thunderclap headache (TCH) is a sudden severe headache that peaks to maximum intensity within 1 minute. Subarachnoid hemorrhage is the most commonly identified etiology for this headache, however, other secondary etiologies should be considered. Sentinel headache, reversible cerebral vasoconstriction syndrome, arterial dissection, cerebral venous sinus thrombosis, pituitary apoplexy, intracranial hemorrhage, ischemic stroke, reversible posterior leukoencephalopathy, spontaneous intracranial hypotension, colloid cyst, and intracranial infections are other possible causes of TCH. Investigations for the etiology of TCH begin with noncontrast CT head and lumbar puncture. MR brain, CT angiogram, MR angiogram, or CT/MR venogram may need to be performed if the initial investigations are negative. Treatment and prognosis depend on the etiology of the TCH.

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Conflict of Interest

Esma Dilli has received honoraria from Merck, UCB, Johnson and Johnson, Allergan, and Tribute Pharmaceuticals. Further, she has received payments for development of educational presentations from Medical Education Speakers Network and Allergan. She also has received paid travel/accommodations expenses from the Canadian Headache Society for a Headache Course for Canadian neurology residents.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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  1. Department of Medicine, Division of Neurology, University of British Columbia, 8219-2775 Laurel Street, Vancouver, BC, V5Z 1M9, Canada

    Esma Dilli

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Dilli, E. Thunderclap Headache. Curr Neurol Neurosci Rep 14, 437 (2014). https://doi.org/10.1007/s11910-014-0437-9

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