What Causes Thunderclap Headaches?
A thunderclap headache, as the name implies, is a headache that comes on suddenly and severely like a thunderclap. The pain reaches a peak in sixty seconds or less. It's uncommon for individuals to experience thunderclap headaches, but they should never be treated lightly. There are many potential causes of thunderclap headaches, many of which are life-threatening. The most common are related to bleeding around or inside the brain. Patients who experience a thunderclap headache should get emergency medical care. Doctors may do a number of tests to try to determine the headache's cause, including a lumbar puncture, MRI, CT scan, or MRA. The treatment depends largely on the underlying cause. If the headache's cause isn't diagnosed in the emergency room, patients might be referred to a neurologist who can run further tests. Prior to this appointment, patients should list their medical history, medications, symptoms, and questions they have.
Cerebrospinal Fluid Leak
A thunderclap headache can be brought on by a cerebrospinal fluid leak. In these cases, the leak usually occurs because the covering surrounding one of the spine's nerve roots was torn. Cerebrospinal fluid is responsible for protecting and cushioning the spinal cord and brain. Holding the fluid in place is the meninges, a covering that resembles a sac. The thickest outside layer of this covering is the dura. In ordinary circumstances, an individual's brain floats in their cerebrospinal fluid. However, a leak occurs when there is a tear or hole in the dura, which makes the fluid leak out. The lowering volume of cerebrospinal fluid makes the brain sag in the skull rather than floating. This leads to headaches that become worse when the person is standing or sitting upright. Sometimes a cerebrospinal fluid leak occurs following medical procedures like spinal surgery, steroid epidural injections, or lumbar punctures. Sometimes, though, the cause of the leak isn't easily identified.
Subarachnoid Hemorrhage
A subarachnoid hemorrhage can lead to thunderclap headaches. This condition is a kind of life-threatening stroke that occurs when there's bleeding in the area around the brain. There are multiple possible causes of subarachnoid hemorrhages including head injuries, ruptured aneurysms, or a brain arteriovenous malformation. Arteriovenous malformations are knots or tangles of abnormal blood vessels responsible for connecting the brain's veins and arteries. One-third of patients who experience a subarachnoid hemorrhage survive and recovery well, another third survive but have a permanent disability, and the last third pass away. These types of strokes must be treated as soon as possible to stop the bleeding and restore the normal flow of blood in the brain. Like a cerebrospinal fluid leak, the thunderclap headache is related to cerebrospinal fluid. When there's bleeding into the area around the brain, the brain's lining becomes irritated. There's also increased pressure against the brain as well as damage to the brain cells.
