Thunderclap Headaches

The abrupt onset of severe headache, unlike any experienced before, can be a terrifying experience, and most often requires urgent medical attention. Although many times no cause is found, the first worst headache can be the signal of something very serious. Thunderclap headaches are severe headaches coming on full force in less than a minute, lasting at least 5 minutes, and often appearing without any trigger. They can be divided broadly into two 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, following medical evaluation, are felt to be benign, or not dangerous. Abrupt severe headaches triggered by activity, including sexual activity or straining to have a bowel movement, or headaches coming on after an injury, are particularly suspicious as possibly being dangerous. Any thunderclap headache accompanied by fever, weakness, loss of vision or sensation, or accompanied by confusion or changes in speech or thinking, needs immediate evaluation. The possible problems that can result in thunderclap headache are many, and the consequences can be so severe that this Headache Toolbox is longer than most in order to describe this type of headache and its many causes.