Saturday, September 25

Thunderclap headache, an unexpected and severe headache

Headaches, a localized pain in the head, are one of the most common disorders of the nervous system. With a worldwide prevalence of almost 50%, almost half of the adult population has suffered at least one episode of headache in the last year, according to the World Health Organization (whoBut not all headaches are the same.

Broadly speaking, the classification distinguishes between primary headaches (such as migraine or tension headache) and high schools (due to another process). Depending on factors such as the patient’s age, family and personal history, type of pain, and other clinical criteria, it may be one type or another.

Although headaches can sometimes be painful and debilitating, most can be treated and go away in several hours. However, certain types of headache can be a sign of something more serious.

Sudden, severe thunderclap headache

A thunderclap headache is a severe form of headache that comes on suddenly, like “thunderclap,” as the name suggests, and usually peaks within 30 seconds to a minute. People who suffer from it often refer to it as the worst headache of their life.

The International Headache Society (IHS) defines this type of headache as a “high intensity headache with an abrupt onset that mimics that of a ruptured cerebral aneurysm, in the absence of intracranial pathology”.

This medical emergency, which often appears without a trigger, is very different from any other more common headache, such as migraine headaches and tension headaches.

According to the classification criteria of the International Classification of Headache DisorderSymptoms include a sudden onset of severe pain intensity that peaks in one minute and lasts for about five minutes.

The main causes of thunder headache

This type of thunder pain is associated with a variety of causes, ranging from more benign to more serious such as vascular problems and structural injuries or abnormalities. This means that a thorough study must be carried out to ensure that nothing serious happens and to rule out more serious problems.

A thunderclap headache can be attributed to major intracranial vascular disorders, especially subarachnoid hemorrhage, a bleeding that occurs in the meninx, the covering of the brain (between the brain and the skull bone). In most cases, aneurysms are produced after the rupture of dilations in the cerebral arteries, whose risk factors are usually “advanced age, poorly controlled high blood pressure, smoking and the consumption of drugs such as cocaine” , recognizes in the blog ‘Cefablog” Dr. Carlos Ordás, specialist of the Neurology Service of the Rey Juan Carlos University Hospital.

The severe headache may also be accompanied in this case by other symptoms such as a stiff neck, impaired strength or sensitivity of a part of the body, double vision or loss of vision, impaired language and, in some cases, drowsiness. and low level of consciousness.

Although subarachnoid hemorrhage is often the first diagnosis to keep in mind and the first to rule out, there are other causes of pain, such as reversible cerebral vasoconstriction syndrome, posterior reversible encephalopathy or central nervous system angeitis; as well as other entities that may occasionally present themselves with this form of headache such as arterial dissection, cerebral venous thrombosis, or loss of intracranial pressure. And all of them can manifest as thunder headache.

Also primary headaches, such as those caused by physical exertion, can appear with this type of headache.

What is the treatment for thunder headache

The tests most often used to try to determine the cause of a thunderclap headache are a CT scan of the head that takes cross-sectional images of the brain; a lumbar puncture to remove a small amount of the fluid that surrounds the brain and spinal cord; an MRI as an additional test; and an MRI angiogram to map blood flow to the brain.

As the specialist admits, with urgent care, the aneurysm can be closed “by arterial catheterization.” Treatment includes admission and surveillance to detect, early, any possible complications in the short and medium term. “If the care is quick and the bleeding is not massive, in most cases the prognosis is usually good”, reassures Ordás.