All types of headaches have primary and secondary causes:
Since it’s impossible to know for certain if you’re having a primary or secondary thunderclap headache, it’s important to seek immediate medical attention if you experience one. Causes of secondary thunderclap headaches include:
Thunderclap headaches are a medical emergency, and it’s important to assess them for an underlying cause. If healthcare providers find the cause, they tailor the treatment to address it. Some thunderclap headaches require surgery to repair torn or ruptured blood vessels. Your provider will determine the best treatment option based on the cause of the headache.
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If a thunderclap headache isn’t associated with an urgent underlying condition (a primary thunderclap headache), your healthcare provider may treat it with medication. A nonsteroidal anti-inflammatory (NSAID) medicine can help reduce swelling.
Because they come on without warning, it’s difficult to prevent thunderclap headaches. Managing underlying health conditions and avoiding triggers are the best ways to keep them from occurring. If you have high blood pressure or vascular problems, it’s important to work with your healthcare provider to follow a regular treatment plan.
Maintaining a healthy diet and active lifestyle helps keep blood pressure from rising to levels that could cause a condition involving a thunderclap headache. In addition, quitting smoking and controlling cholesterol levels can help reduce the risk of blood vessel problems.
For some people, activities such as heavy exertion and sexual activity can trigger thunderclap headaches. Once you identify these triggers, avoiding them can help reduce the number of headaches you experience. Your healthcare provider can recommend treatment options, including medications, to reduce your likelihood of repeated thunderclap headaches.
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Go to the emergency room if you’re experiencing a thunderclap headache for the first time. It’s urgent to determine if a dangerous condition is the underlying cause so it can be treated quickly if necessary. Some conditions associated with a thunderclap headache can be fatal without prompt treatment.
Some questions you may want to ask your doctor about thunderclap headaches include:
If a thunderclap headache isn’t caused by a serious underlying condition, people typically resume their usual activity as soon as the headache passes. The lengths of these headaches vary, but medications often provide relief within hours. Recovery times vary for people when an underlying condition causes a thunderclap headache. People who need brain surgery may require several weeks or even months of recovery before they return to normal activities.
Everyone gets headaches from time to time for various reasons. But thunderclap headaches are no ordinary headaches. If you experience sudden, severe pain in your head — the worst headache you’ve ever had — go to the emergency room. A healthcare provider will order tests to determine if a more serious medical condition is causing it.
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If you have a neurological condition, you want expert advice. At Cleveland Clinic, we’ll work to create a treatment plan that’s right for you.
Last reviewed on 10/12/2022.
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