Thunderclap Headaches

What are Thunderclap Headaches?

Thunderclap headaches come on very strong and very fast and can hit their peak in only 6 seconds.

Some people find relief in as little as an hour but they can sometimes last as long as 10 days. They can occur for a variety of reasons, some of them very serious.

Sometimes a thunderclap headache is simply the result of hitting hot water too fast or difficult physical labor. It can also be a side effect of some drugs (both prescription and illegal drugs).

A thunderclap headache can also be a sign of something more serious such as leaking spinal fluid, blocked veins in the head, an aneurysm, a brain infection or major changes in blood pressure.

What are the Symptoms of Thunderclap Headaches?

Thunderclap headaches happen very quickly and usually occur on the head or neck but sometimes can be felt in the back, too.

Beside severe pain, thunderclap headaches can come with nausea and vomiting, weakness, confusion, numbness and changes in vision.

Causes of Thunderclap Headaches

The most common cause is a reversible cerebral vasoconstriction that occurs without warning. It happens when the arterial walls in the brain contract and restrict the flow of blood. These arteries are essential blood paths for healthy brain functions. The lack of blood causes life threatening headaches with severe pain in need of immediate medical attention.

Pressure changes inside of the skull can cause thunderclap headaches, delivering a sense of throbbing and tightness accompanied with pain. Low pressure changes to the skull may cause headaches that last only a few minutes compared to the high pressure changes increasing the pain level.

If you’ve experienced a fall or injury to the head, the trauma will trigger a change in cranium pressure leading to a thunderclap headache. A tumor will also change the brain’s pressure, causing a headache.

There are several infrequent causes of these headaches. There’s a fluid sack located at the lower spine, when it’s ruptured, a thunderclap headache occurs. A viral bacterium called meningitis brings fever and stiff necks causing thunderclap headaches in a small percentage of patients. In some cases, simple tasks like taking a hot bath can set off the headache.

How are Thunderclap Headaches Treated?

The treatment of a thunderclap headache will depend on what the cause is.  If the cause is something minor, like working too hard, analgesics can relieve the pain.  Your doctor will likely want to find out what the main cause of the headaches are though and this can include getting an MRI or a CT scan of your brain.

A spinal tap test can check your spinal fluid.  Doctors may recommend calcium-channel blockers if high blood pressure is the cause and these blockers can relieve the pain of thunderclap headaches.

Prevention of Thunderclap Headaches

Thunderclap headaches need a specialist for monitoring the current frequency and the history leading up to this health incident. Examinations and tests include CT scans and brain magnetic resonance images looking for brain disorders involving blood vessels and hemorrhages.

A leak in the spinal sack causing headaches requires an epidural blood patch – a blood injection into the lower spine. Your own blood is drawn to plug the leak and stop the headaches.

Depending on the severity and other existing health conditions, calcium channel blockers help to relax and open the blood vessels allowing blood flow to prevent thunderclap headaches.

Last Reviewed:
October 11, 2016
Last Updated:
September 11, 2017