Overview

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.

Symptoms

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
  • Fever
  • Seizures

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.

Causes

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. 02, 2018
References
  1. Schwedt TJ, et al. Approach to the patient with thunderclap headache. https://www.uptodate.com/contents/search. Dec. 17, 2017.
  2. Riggins EA. Allscripts EPSi. Mayo Clinic, Rochester, Minn. Dec. 15, 2017.
  3. 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.
  4. Olesen J, et al. The international classification of headache disorders, 3rd edition (beta version). Cephalia. 2013;33:629.

Connect with others

News, connections and conversations for your health

Recent posts