The remainder are secondary to a number of conditions, including:
Subarachnoid hemorrhage (10–25% of all cases of thunderclap headache)
Cerebral venous sinus thrombosis
Cervical artery dissection
Hypertensive emergency (severely raised blood pressure)
Spontaneous intracranial hypotension (unexplained low cerebrospinal fluid pressure)
Stroke (headache occurs in about 25% of strokes but usually not thunderclap character)
Retroclival hematoma (hematoma behind the clivus in the skull, usually due to physical trauma but sometimes spontaneous)
Pituitary apoplexy (infarction or hemorrhage of the pituitary gland)
Colloid cyst of the third ventricle
Meningitis, sinusitis
Reversible cerebral vasoconstriction syndrome (previously Call-Fleming syndrome, several subtypes)
Primary cough headache, primary exertional headache, and primary sexual headacheThe most important of the secondary causes are subarachnoid hemorrhage, cerebral venous sinus thrombosis, and dissection of an artery in the neck.In subarachnoid hemorrhage, there may be syncope (transient loss of consciousness), seizures, meningism (neck pain and stiffness), visual symptoms, and vomiting. 50–70% of people with subarachnoid hemorrhage have an isolated headache without decreased level of consciousness. The headache typically persists for several days.Cerebral venous sinus thrombosis, thrombosis of the veins of the brain, usually causes a headache that reflects raised intracranial pressure and is therefore made worse by anything that makes the pressure rise further, such as coughing. In 2–10% of cases, the headache is of thunderclap character.
The remainder is attributed to secondary causes: vascular problems, infections and various other conditions. History
The importance of severe headaches in the diagnosis of subarachnoid hemorrhage has been known since the 1920s, when London neurologist Charles Symonds described the clinical syndrome. The term "thunderclap headache" was introduced in 1986 in a report by John Day and Neil Raskin, neurologists at the University of California, San Francisco, in a report of a 42-year-old woman who had experienced several sudden headaches and was found to have an aneurysm that had not ruptured. References
Further reading
Dodick, DW (1 January 2002). "Thunderclap headache". Journal of Neurology, Neurosurgery & Psychiatry. 72 (1): 6–11. doi:10.1136/jnnp.72.1.6. PMC 1737692. PMID 11784817. Ju, Yo-El; Schwedt, Todd (29 March 2010). "Abrupt-Onset Severe Headaches". Seminars in Neurology. 30 (2): 192–200. doi:10.1055/s-0030-1249229. PMC 3558726. PMID 20352589. Ducros, A; Bousser, MG (9 January 2013). "Thunderclap headache". BMJ. 346 (jan08 15): e8557. doi:10.1136/bmj.e8557. PMID 23303883. S2CID 2537784. == External links ==