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Devika V. S., Krishna MOL J., Sakkeena A., Abhiram R. Sajeev, E. Samjeeva Kumar* and Prasobh G. R.


The term “thunderclap headache” (TCH) was first coined by Day and Raskin in 1986. Thunderclap headache (TCH) is head pain that begins suddenly and severe onset. Thunderclap headaches are rare. Headache will occur in less than 50 out of 100,000 people each year. Causes of thunderclap headaches include: Torn or ruptured blood vessels in the brain, Stroke (blocked or bleeding blood vessel), Brain aneurysm (bulging or bleeding blood vessel), Head injury that causes a brain bleed, Vasculitis etc. The main symptom in this type of headache is sudden and severe pain in the head. This pain reaches at its peak point within 60 seconds and lasts at least 5 minutes. Other symptoms may include: Numbness, Weakness, Speech problems etc. Thunderclap headaches are diagnosed with an imaging test called a CT-Angiogram scan. This result shows the doctor the blood vessels in and around the brain to see what is the reason for pain. Other tests include spinal tap, Magnetic resonance imaging (MRI) and lumbar puncture. A non-steroidal anti-inflammatory (NSAID) medicine can help reduce swelling. Other drugs can manage blood pressure. If the thunderclap headache is caused by spasms in the brain’s blood vessels, IV or oral nimodipine may be given. This disease is also associated with angiographic evidence of diffuse multifocal cerebral vasospasm. Eventough this unusual angiographic abnormality is reversible and self limited, careful clinical observation is warranted, especially the focal neurological symptoms occur.

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