In plain words
A thunderclap headache is a sudden, severe headache that peaks within about a minute. People often describe it as the worst headache of their life. It is different from a usual headache because it arrives fast. Many causes exist, and some are dangerous, including bleeding around the brain and problems with blood vessels. After birth, one cause is , which narrows blood vessels in the brain. Clinicians treat this as urgent until other causes are excluded. If a headache comes on suddenly and severely, call 911 or go to the nearest emergency room now. Emergency care is the right call, not a wait-and-see.
The deeper version
Defined by peak intensity within one minute (ICHD-3). Differential diagnosis is urgent and includes subarachnoid hemorrhage, cervical artery dissection, pituitary apoplexy, and reversible cerebral vasoconstriction syndrome (RCVS), which is segmental arterial constriction, often postpartum, and is linked to vasoactive exposures and pregnancy. Neuroimaging with vascular assessment is standard, with lumbar puncture used when imaging is negative. RCVS usually resolves over weeks, but stroke and recurrence are reported. Postpartum cohorts are small.
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Sources
- International Headache Society — International Classification of Headache Disorders, 3rd edition (ICHD-3), 2018
- American Heart Association and American Stroke Association — Guidelines for the Management of Aneurysmal Subarachnoid Hemorrhage, 2023