Current Neurology and Neuroscience Reports

, 14:437

Thunderclap Headache


  • Esma Dilli
    • Department of Medicine, Division of NeurologyUniversity of British Columbia
Headache (R Halker, Section Editor)

DOI: 10.1007/s11910-014-0437-9

Cite this article as:
Dilli, E. Curr Neurol Neurosci Rep (2014) 14: 437. doi:10.1007/s11910-014-0437-9
Part of the following topical collections:
  1. Topical Collection on Headache


Thunderclap headache (TCH) is a sudden severe headache that peaks to maximum intensity within 1 minute. Subarachnoid hemorrhage is the most commonly identified etiology for this headache, however, other secondary etiologies should be considered. Sentinel headache, reversible cerebral vasoconstriction syndrome, arterial dissection, cerebral venous sinus thrombosis, pituitary apoplexy, intracranial hemorrhage, ischemic stroke, reversible posterior leukoencephalopathy, spontaneous intracranial hypotension, colloid cyst, and intracranial infections are other possible causes of TCH. Investigations for the etiology of TCH begin with noncontrast CT head and lumbar puncture. MR brain, CT angiogram, MR angiogram, or CT/MR venogram may need to be performed if the initial investigations are negative. Treatment and prognosis depend on the etiology of the TCH.


Thunderclap headache Subarachnoid hemorrhage Aneurysm ∙ Reversible cerebral vasoconstriction syndrome Reversible posterior leukoencephalopathy Sentinel headache Cerebral venous sinus thrombosis Arterial dissection Pituitary apoplexy Spontaneous intracranial hypotension Colloid cyst

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© Springer Science+Business Media New York 2014