Thunderclap headache (sudden severe headache)

2021-09-07 11:14 PM

A thunderclap headache or sudden severe headache is described as an outburst of thunder. The pain is sudden and severe at the top of the head within 60 seconds 

Thunderclap headache (sudden severe headache)

Thunderclap headache (or sudden severe headache)


A thunderclap headache or sudden severe headache is described as an outburst of thunder. The pain is sudden and severe at the top of the head within 60 seconds and may begin to subside after an hour. However, some can last more than a week.

A sudden severe headache is common but can be a warning sign of potentially life-threatening problems - often with bleeding in and around the brain. That's why it's so important to seek emergency medical attention if you experience a sudden severe headache.


Symptoms of a sudden severe headache include:

Sudden and severe headache - sometimes described as the worst headache ever experienced.

Peak headache within 60 seconds.

Lasts for about an hour to 10 days.

Can occur anywhere in the head or neck.

May be accompanied by nausea or vomiting.

Seek immediate medical attention if the headache is sudden and severe.


A sudden severe headache that comes on for no apparent physical reason. In other cases, a potentially life-threatening problem may be the cause, including:

Bleeding between the brain and the membrane covering the brain.

Broken blood vessels in the brain.

Damage to the lining of an artery (eg, carotid or vertebral artery) that supplies blood to the brain.

CSF leaks are usually caused by a tear in the covering around the spinal nerve root.

A tumor in the third ventricle blocks the flow of cerebrospinal fluid.

Tissue necrosis or pituitary bleeding.

Blood clot in the brain.

Severe hypertension.

Have an infection such as meningitis or encephalitis.

Testing and diagnosis

The following tests are commonly used to determine if there is an underlying problem causing a sudden severe headache:

Computed tomography (CT scan) of the brain

Diagnosis usually begins with a CT scan of the head to look for the underlying cause of the headache. CT scans use x-rays to create cross-sectional images (such as slices) of the brain and head. These images are combined by a computer to create a full picture of the brain. Sometimes dyes are used to enhance the image.

Lumbar puncture

A lumbar puncture may be needed. With this procedure, the doctor removes a small amount of fluid that surrounds the brain and spinal cord. CSF samples may be checked for signs of bleeding or infection.

Magnetic resonance imaging (MRI)

In some cases, magnetic resonance imaging (MRI) may be done for further evaluation. With this imaging study, a magnetic field and radio waves are used to create cross-sectional images of structures inside the brain.

Magnetic resonance imaging can also be used to map blood flow in the brain called an MRA.

Treatments and drugs

There is no single treatment for a sudden severe headache because so many potential causes exist. Treatment is aimed at the underlying problem causing the headache - if found.

No treatment exists if the underlying cause is not found.

Coping and supporting

It may be helpful to talk to other people who experience sudden severe headaches. Try searching for a support group in your area to learn how others deal with their headaches and discomfort.