Thunderclap headaches live up to their name, striking suddenly like a clap of thunder. The pain of these severe headaches peaks within 60 seconds.
Thunderclap headaches are uncommon, but they can warn of potentially life-threatening conditions — usually having to do with bleeding in and around the brain. Seek emergency medical attention for a thunderclap headache.
Thunderclap headaches are dramatic. Symptoms include pain that:
- Strikes suddenly and severely
- Peaks within 60 seconds
- Can be accompanied by nausea or vomiting
Thunderclap headaches might be accompanied by other signs and symptoms, such as:
- Altered mental state
These signs and symptoms might reflect the underlying cause.
When to see a doctor
Seek immediate medical attention for any headache that comes on suddenly and severely.
There's no obvious cause for some thunderclap headaches. In other cases, a variety of potentially life-threatening conditions might be responsible, including:
- Bleeding between the brain and membranes covering the brain (subarachnoid hemorrhage)
- A rupture of a blood vessel in the brain
- A tear in the lining of an artery that supplies blood to the brain
- Leaking of cerebrospinal fluid — usually due to a tear of the covering around a nerve root in the spine
- Death of tissue or bleeding in the pituitary gland
- A blood clot in the brain
- Severe elevation in blood pressure (hypertensive crisis)
- Infection such as meningitis or encephalitis
- Ischemic stroke
Thunderclap headaches care at Mayo Clinic
Feb. 04, 2020
- Schwedt TJ, et al. Approach to the patient with thunderclap headache. https://www.uptodate.com/contents/search. Dec. 17, 2017.
- Brown AY. Allscripts EPSi. Mayo Clinic. Nov. 12, 2019.
- Devenney E, et al. A systematic review of causes of sudden and severe headache (thunderclap headache): Should lists be evidence based? The Journal of Headache and Pain. 2014;15:49.
- Olesen J, et al. The international classification of headache disorders, 3rd edition (beta version). Cephalia. 2013;33:629.