Materiały źródłowe

• #1 Thunderclap Headache: What It Is, Causes & Symptoms

  https://my.clevelandclinic.org/health/symptoms/17876-thunderclap-headaches

  A thunderclap headache is a rare type of headache thats extremely painful and comes on suddenly. It can be a sign of blood vessel issues or bleeding in your brain. Because of this, a thunderclap headache requires immediate medical attention. […] Its important to seek medical attention immediately to rule out life-threatening causes of a thunderclap headache. […] Thunderclap headaches are a medical emergency, and its 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. […] Go to the emergency room if youre experiencing a thunderclap headache for the first time. Its 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. […] A healthcare provider will order tests to determine if a more serious medical condition is causing it.

• #2 Thunderclap headaches: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/thunderclap-headaches

  Thunderclap headaches are severe headaches that develop rapidly. They can be a sign of a serious underlying medical condition, such as stroke. As such, they require immediate medical attention. […] A thunderclap headache is a severe headache with a rapid onset. While other types of headache build up slowly, thunderclap headaches tend to peak within 60 seconds. They typically occur without an obvious trigger. […] In some cases, a thunderclap headache may indicate a serious underlying medical condition that requires urgent treatment. As such, anyone who experiences this type of headache should seek immediate medical attention. […] The primary symptom of a thunderclap headache is severe head pain. The pain reaches full intensity within a minute and lasts at least 5 minutes. […] The treatment for a thunderclap headache depends on its cause. If a person experiences a thunderclap headache without a known cause, they must seek immediate medical treatment.

• #3 Thunderclap Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560629/

  Patients presenting with a thunderclap headache (TCH) may describe their pain as the worst headache ever or worst headache of my life. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency, requiring a rapid, focused evaluation. […] A focused history and neurologic examination will help differentiate TCH from other headache types, narrow the secondary TCH differential diagnoses, and guide the initial testing phase. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency. […] The absence of associated symptoms and a normal physical examination do not exclude a serious etiology of secondary TCH. […] Managing patients presenting with TCH requires an interprofessional team of clinicians, including physicians, physician assistants, nurses, nurse practitioners, pharmacists, and ancillary staff. […] Nurses play a valuable role in coordinating activities among the various clinicians on the case, ensuring the patient is informed about the latest developments. […] This interprofessional paradigm will result in the best patient outcomes with the fewest adverse events.

• #4 Thunderclap Headache: What It Is, Causes & Symptoms

  https://my.clevelandclinic.org/health/symptoms/17876-thunderclap-headaches

  A thunderclap headache is a rare type of headache thats extremely painful and comes on suddenly. It can be a sign of blood vessel issues or bleeding in your brain. Because of this, a thunderclap headache requires immediate medical attention. […] Its important to seek medical attention immediately to rule out life-threatening causes of a thunderclap headache. […] Thunderclap headaches are a medical emergency, and its 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. […] Go to the emergency room if youre experiencing a thunderclap headache for the first time. Its 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. […] A healthcare provider will order tests to determine if a more serious medical condition is causing it.

• #5 Thunderclap Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560629/

  Patients presenting with a thunderclap headache (TCH) may describe their pain as the worst headache ever or worst headache of my life. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency, requiring a rapid, focused evaluation. […] A focused history and neurologic examination will help differentiate TCH from other headache types, narrow the secondary TCH differential diagnoses, and guide the initial testing phase. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency. […] The absence of associated symptoms and a normal physical examination do not exclude a serious etiology of secondary TCH. […] Managing patients presenting with TCH requires an interprofessional team of clinicians, including physicians, physician assistants, nurses, nurse practitioners, pharmacists, and ancillary staff. […] Nurses play a valuable role in coordinating activities among the various clinicians on the case, ensuring the patient is informed about the latest developments. […] This interprofessional paradigm will result in the best patient outcomes with the fewest adverse events.

• #6 Thunderclap Headaches | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/thunderclap-headaches/

  Thunderclap headaches come on quickly without warning and are extremely painful—and they can be a sign of something serious. Learn how to spot a thunderclap headache and what to do if you experience one. […] A thunderclap headache feels like a sudden, severe headache that comes on within less than a minute. This extremely abrupt onset and head pain unlike any you’ve experienced before can be a terrifying experience, and most often requires urgent medical attention. Although many times no cause is found, the first occurrence of a thunderclap headache can be a sign of something very serious. […] Thunderclap headaches are severe headaches coming on full force in less than a minute, lasting at least 5 minutes, and often appearing without any trigger. The pain may be felt anywhere in the head and may in some cases extend down the back of the neck.

• #7 Understanding Thunderclap Headaches – Expert Insights from Neurosurgeons

  https://www.kauveryhospital.com/blog/neurology/all-about-thunderclap-headaches/

  Thunderclap headaches are a type of headache marked by sudden, sharp, intense and unbearable pain that can last up to a minute. The intense pain will subside, while mild pain can last up to 72 hours. […] Thunderclap headaches are another class of headaches. In this, the person experiences sudden and intense pain like he/she has never experienced before with the pain being unbearable. That is why it is compared to a thunderclap. The intense pain or the ‘peak’ lasts for a minute to 90 seconds. Then the peak subsides and there is a less intense pain which can last up to 72 hours. In some people, the condition can recur in the days or weeks following the first peak. […] Thunderclap headaches are a severe type of headache which can be life-threatening if left untreated due to the potential serious underlying causes. This condition requires immediate medical attention and management. Diagnosis involves imaging tests to reveal intricate details of the brain’s vascular system and the treatment strategy depends largely on the underlying cause. Primary thunderclap headaches can be managed with NSAIDs, however, secondary headaches require a more focused treatment plan targeting the cause, which may include medication, surgery, or supportive care.

• #8 Overview of thunderclap headache – UpToDate

  https://www.uptodate.com/contents/overview-of-thunderclap-headache/print

  Thunderclap headache (TCH) refers to a severe headache of sudden onset. Its explosive and unexpected nature is likened to a „clap of thunder.” Multiple etiologies may cause TCH (table 1). This topic will review the clinical presentation, etiologies, and diagnostic evaluation of TCH. […] A TCH is a very severe headache of abrupt onset that reaches its maximum intensity within one minute or less of onset. The key feature that differentiates TCH from other headaches is the rapidity with which it develops; extreme severity alone is insufficient. […] By definition, TCH is a very severe headache that begins abruptly and reaches maximum intensity within one minute or less of onset. Patients may present with TCH either in isolation or accompanied by additional symptoms and signs (eg, meningismus, fever, tinnitus, orthostatic worsening of headache, altered mental state, seizure, motor or sensory deficits, or cranial nerve palsies) that reflect the underlying cause. […] Given the serious and potentially life-threatening nature of underlying intracranial etiologies (table 1), TCH is a medical emergency requiring immediate evaluation.

• #9 Thunderclap Headaches: Definition, Symptoms, Treatments

  https://resources.healthgrades.com/right-care/migraine-and-headache/thunderclap-headaches

  Thunderclap headaches (TCH) are sudden, severe headaches. Pain can peak within 30 seconds to 1 minute after the headache begins. […] A secondary TCH typically results from an intracranial vascular disorder. In rare cases, a primary TCH can occur when there is no underlying condition for the headache. […] The main symptom of a thunderclap headache (TCH) is the abrupt onset of severe, explosive headache pain. It worsens within a few minutes and can last anywhere from 5 minutes to a few hours. […] Treatments for a thunderclap headache (TCH) include calcium channel blockers, such as nimodipine, nonsteroidal anti-inflammatory drugs and other pain relievers, acetaminophen, beta-blockers, topiramate and lithium in lower dosages. […] If you experience a secondary TCH, you will require treatment for the underlying cause. Your doctor can explain what treatment options are available to you, depending on the condition. […] It is important to receive treatment for a thunderclap headache (TCH) as soon as you experience it, as some causes of TCH can be life threatening. […] It is important to contact your doctor as soon as you experience a TCH. Medical professionals usually treat this condition as an emergency.

• #10 Thunderclap Headaches: Causes, Symptoms, and Treatments

  https://www.denveruppercervical.com/thunderclap-headache

  A thunderclap headache feels like a severe headache from nowhere with an overwhelming level of headache pain. It reaches its maximum intensity within 1 minute from onset. […] Direct symptoms of a thunderclap headache include: Sudden onset headache, Severe head pain. […] Call your doctor when Thunderclap headaches can be very serious since they may indicate your blood vessels are damaged or blocked, triggering a life-threatening stroke. […] A medical professional can determine if you are suffering from a stroke or another severe condition that requires prompt treatment. […] What can cause thunderclap headaches? Here are the most common triggers of thunderclap headaches: Aneurysmal subarachnoid hemorrhage, Reversible cerebral vasoconstriction syndrome, Blood vessel problems, Ischemic stroke, Hemorrhagic stroke, Cerebral aneurysm, Cerebral venous sinus thrombosis, Spontaneous intracranial hypotension, Spontaneous spinal epidural hematoma, Pituitary apoplexy, Sexual activity, Intense exercise, Infection in the brain, Head injury or trauma.

• #11 Thunderclap Headaches: Why You Should Watch Out for Sudden Onset of Pain — Migraine Again

  https://www.migraineagain.com/thunderclap-headaches/

  Thunderclap headache can be a sign of a more serious condition, like bleeding in or around the brain, so an emergent evaluation is necessary if you experience a headache like this. […] It is first important to determine if there is a cause of the thunderclap headache, and if so, treating the problem can prevent a worsening situation. […] If the thunderclap headache does not have a cause, which can occur in a portion of cases, then often the headache will improve on its own; however, in these cases there are often recurrent thunderclap headaches. […] For either the experienced headache person or for the person who has never had a headache before, having the worst headache of your life is something to take seriously and should be evaluated emergently as it may represent a more serious underlying condition. […] In rare cases, there is no underlying cause for a thunderclap headache.

• #12 Headaches Not to Miss Regardless of the Patient Population: Thunderclap Headache in the Emergency Department

  https://practicalneurology.com/diseases-diagnoses/alzheimer-disease-dementias/headaches-not-to-miss-regardless-of-the-patient-population-thunderclap-headache-in-the-emergency-department/32004/

  Most people presenting to the emergency department (ED) with headache are imaged with a noncontrast CT (NCCT) scan of the head. […] Providers typically are aware that thunderclap headache is a not-to-miss diagnosis and that thunderclap headache reaches severe intensity within 1 minute of onset. […] The following cases illustrate various clinical presentations of thunderclap headache and highlight associated signs and symptoms that should prompt further investigation beyond NCCT scans. […] Headache is the presenting symptom in approximately 70% of people with subarachnoid hemorrhage (SAH) and half of these individuals describe symptoms associated with thunderclap headache. […] SAH accounts for 25% of individuals presenting with thunderclap headache. […] Thunderclap headache is the sole manifestation of RCVS in 75% of cases, typically lasting 1 to 3 hours in duration.

• #13 Thunderclap headache: when the risk of doing nothing is too high | Medicine Today

  https://medicinetoday.com.au/mt/2017/july/feature-article/thunderclap-headache-when-risk-doing-nothing-too-high

  About 70% of patients with SAH present with headaches as the main symptom, and about 50% of these present with thunderclap headache. SAH is found in up to 25% of patients with thunderclap headache. Aneursymal SAH is therefore the diagnosis of foremost consideration in this scenario. […] Treatment of SAH is highly specialised and patients require management in a well-equipped expert neurosurgical unit. Management includes supportive care and avoidance of vasoconstriction, which may produce cerebral ischaemia. The cornerstone of treatment is to prevent further bleeding from the cause (usually an aneurysm). This requires surgical securing of the aneurysm (by clipping) or endovascular treatment (with coils and similar devices). […] A thunderclap headache is an uncommon presentation of headache but is important to recognise because it should prompt urgent medical review and investigation as it is often associated with serious vascular intracranial disorders. Aneurysmal SAH is the foremost consideration. Understanding of RCVS is expanding and this is probably the next most common cause for thunderclap headache.

• #14 Thunderclap Headaches: Causes, Symptoms, and Treatments

  https://www.denveruppercervical.com/thunderclap-headache

  A thunderclap headache feels like a severe headache from nowhere with an overwhelming level of headache pain. It reaches its maximum intensity within 1 minute from onset. […] Direct symptoms of a thunderclap headache include: Sudden onset headache, Severe head pain. […] Call your doctor when Thunderclap headaches can be very serious since they may indicate your blood vessels are damaged or blocked, triggering a life-threatening stroke. […] A medical professional can determine if you are suffering from a stroke or another severe condition that requires prompt treatment. […] What can cause thunderclap headaches? Here are the most common triggers of thunderclap headaches: Aneurysmal subarachnoid hemorrhage, Reversible cerebral vasoconstriction syndrome, Blood vessel problems, Ischemic stroke, Hemorrhagic stroke, Cerebral aneurysm, Cerebral venous sinus thrombosis, Spontaneous intracranial hypotension, Spontaneous spinal epidural hematoma, Pituitary apoplexy, Sexual activity, Intense exercise, Infection in the brain, Head injury or trauma.

• #15 What is a Thunderclap Headache, and How to treat its Symptoms?

  https://driphydration.com/blog/what-is-a-thunderclap-headache-and-how-to-treat-its-symptoms/?srsltid=AfmBOorkQE9U_zB1JjuERl4o07J1ZodzANJurqJ_OmBJJYU2O286AMhh

  A thunderclap headache is usually most painful between 30 seconds to one minute into the headache. Often, it will begin to subside about an hour after the pain reaches its peak, but a thunderclap headache could last for a week or more. […] Postcoital thunderclap headaches may be caused by blood pressure increases and blood vessels dilating during an orgasm. […] Postcoital thunderclap headaches can happen very suddenly. Typically, you will feel an intense pounding sensation in your head immediately before or during an orgasm. […] The most common cause of thunderclap headaches is a type of brain bleed called a subarachnoid hemorrhage. This condition can be life-threatening if it is not treated quickly. […] Common triggers for thunderclap headaches are physical or sexual activity. […] Depending on the cause of your headaches, there are several treatments that may be appropriate.

• #16 Thunderclap Headaches | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/thunderclap-headaches/

  In some cases, a thunderclap headache may be accompanied by fever, weakness, confusion, loss of vision or sensation, or changes in speech or thinking. If you experience any of these symptoms alongside a thunderclap headache, you should seek immediate medical attention. […] Abrupt, severe headaches triggered by activity—including sexual activity or straining to have a bowel movement—or headaches coming on after an injury have especially high potential to be dangerous. […] There is a broad range of possible injuries and underlying conditions that can result in thunderclap headaches, and the consequences can be severe. […] If a patient is evaluated promptly, the problem can often be diagnosed with a CAT scan and a spinal tap or lumbar puncture, in which a sample of spinal fluid is withdrawn from the back and analyzed for the presence of blood.

• #17 Overview of thunderclap headache – UpToDate

  https://www.uptodate.com/contents/overview-of-thunderclap-headache

  CLINICAL PRESENTATION […] By definition, TCH is a very severe headache that begins abruptly and reaches maximum intensity within one minute or less of onset. Patients may present with TCH either in isolation or accompanied by additional symptoms and signs (eg, meningismus, fever, tinnitus, orthostatic worsening of headache, altered mental state, seizure, motor or sensory deficits, or cranial nerve palsies) that reflect the underlying cause. […] Given the serious and potentially life-threatening nature of underlying intracranial etiologies, TCH is a medical emergency requiring immediate evaluation.

• #18 Thunderclap Headaches – Symptoms, Causes,and Treatment

  https://www.webmd.com/migraines-headaches/thunderclap-headaches

  This rare type of severe headache comes on suddenly. It can cause intense pain and often nausea and vomiting. If you have one, get emergency medical attention. The cause, which can be life-threatening, is often some kind of bleeding in or around your brain. […] A thunderclap headache should be treated as an emergency until the cause can be determined. Seek medical attention immediately. […] Thunderclap headache treatment depends on what’s causing the pain.

• #19 Thunderclap Headaches | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/thunderclap-headaches/

  In some cases, a thunderclap headache may be accompanied by fever, weakness, confusion, loss of vision or sensation, or changes in speech or thinking. If you experience any of these symptoms alongside a thunderclap headache, you should seek immediate medical attention. […] Abrupt, severe headaches triggered by activity—including sexual activity or straining to have a bowel movement—or headaches coming on after an injury have especially high potential to be dangerous. […] There is a broad range of possible injuries and underlying conditions that can result in thunderclap headaches, and the consequences can be severe. […] If a patient is evaluated promptly, the problem can often be diagnosed with a CAT scan and a spinal tap or lumbar puncture, in which a sample of spinal fluid is withdrawn from the back and analyzed for the presence of blood.

• #20 Thunderclap Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560629/

  Patients presenting with a thunderclap headache (TCH) may describe their pain as the worst headache ever or worst headache of my life. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency, requiring a rapid, focused evaluation. […] A focused history and neurologic examination will help differentiate TCH from other headache types, narrow the secondary TCH differential diagnoses, and guide the initial testing phase. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency. […] The absence of associated symptoms and a normal physical examination do not exclude a serious etiology of secondary TCH. […] Managing patients presenting with TCH requires an interprofessional team of clinicians, including physicians, physician assistants, nurses, nurse practitioners, pharmacists, and ancillary staff. […] Nurses play a valuable role in coordinating activities among the various clinicians on the case, ensuring the patient is informed about the latest developments. […] This interprofessional paradigm will result in the best patient outcomes with the fewest adverse events.

• #21 Overview of thunderclap headache – UpToDate

  https://www.uptodate.com/contents/overview-of-thunderclap-headache/print

  Thunderclap headache (TCH) refers to a severe headache of sudden onset. Its explosive and unexpected nature is likened to a „clap of thunder.” Multiple etiologies may cause TCH (table 1). This topic will review the clinical presentation, etiologies, and diagnostic evaluation of TCH. […] A TCH is a very severe headache of abrupt onset that reaches its maximum intensity within one minute or less of onset. The key feature that differentiates TCH from other headaches is the rapidity with which it develops; extreme severity alone is insufficient. […] By definition, TCH is a very severe headache that begins abruptly and reaches maximum intensity within one minute or less of onset. Patients may present with TCH either in isolation or accompanied by additional symptoms and signs (eg, meningismus, fever, tinnitus, orthostatic worsening of headache, altered mental state, seizure, motor or sensory deficits, or cranial nerve palsies) that reflect the underlying cause. […] Given the serious and potentially life-threatening nature of underlying intracranial etiologies (table 1), TCH is a medical emergency requiring immediate evaluation.

• #22 Thunderclap Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560629/

  Patients presenting with a thunderclap headache (TCH) may describe their pain as the worst headache ever or worst headache of my life. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency, requiring a rapid, focused evaluation. […] A focused history and neurologic examination will help differentiate TCH from other headache types, narrow the secondary TCH differential diagnoses, and guide the initial testing phase. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency. […] The absence of associated symptoms and a normal physical examination do not exclude a serious etiology of secondary TCH. […] Managing patients presenting with TCH requires an interprofessional team of clinicians, including physicians, physician assistants, nurses, nurse practitioners, pharmacists, and ancillary staff. […] Nurses play a valuable role in coordinating activities among the various clinicians on the case, ensuring the patient is informed about the latest developments. […] This interprofessional paradigm will result in the best patient outcomes with the fewest adverse events.

• #23 Thunderclap headaches – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thunderclap-headaches/diagnosis-treatment/drc-20378366

  The following tests are commonly used to try to determine the cause of a thunderclap headache. […] Our caring team of Mayo Clinic experts can help you with your thunderclap headaches-related health concerns. […] Thunderclap headaches care at Mayo Clinic.

• #24

  https://continentalhospitals.com/diseases/thunderclap-headaches/

  Thunderclap headaches are severe and sudden headaches that reach maximum intensity within 1 minute of onset. These headaches are often described as the worst headache of one’s life. They can be indicative of a serious medical condition such as a ruptured aneurysm, bleeding in the brain, or other neurological issues. Thunderclap headaches require immediate medical attention to determine the underlying cause and begin appropriate treatment. […] If you’re encountering sudden and severe Thunderclap Headaches or have associated risk factors, prompt consultation with a Neurologist is essential. […] Diagnosing thunderclap headaches involves a systematic approach to identify the underlying cause and ensure appropriate treatment. Here are the key diagnostic steps: […] Thunderclap headaches require urgent medical attention to rule out life-threatening conditions such as subarachnoid hemorrhage, aneurysm, or stroke.

• #25 Focus on the management of thunderclap headache: from nosography to treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3072477/

  Thunderclap headache (TCH) is an excruciating headache characterized by a very sudden onset. Recognition and accurate diagnosis of TCH are important in order to rule out the various, serious underlying brain disorders that, in a high percentage of cases, are the real cause of the headache. Primary TCH, which may recur intermittently and generally has a spontaneous, benign evolution, can thus be diagnosed only when all other potential underlying causes have been excluded through accurate diagnostic work up. […] In this review, we focus on the management of TCH, paying particular attention to the diagnostic work up and treatment of the condition. […] While defining the diagnosis, TCH must always be managed as a medical emergency in order to avoid potentially catastrophic consequences that can occur with secondary TCH. The initial diagnostic assessment must be aimed at ruling out SAH. Non-contrast brain CT is the first examination in this assessment, to be performed within the first 12 h after the onset of the headache, preferably using third-generation CT scanners that have a specificity of 98% and a sensitivity close to 100%.

• #26 Acute Headache in Adults: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/acute-headache-adults.html

  A detailed history and physical examination can distinguish between key features of benign primary headaches and concerning symptoms that warrant further evaluation for a secondary headache. […] Red flag signs or symptoms such as acute thunderclap headache, fever, meningeal irritation on physical examination, papilledema with focal neurologic signs, impaired consciousness, and concern for acute glaucoma warrant immediate evaluation. […] Patients with acute thunderclap headache should be sent to the emergency department and should receive computed tomography of the head within 12 hours of symptom onset. […] Immediate evaluation is necessary for acute thunderclap headache because of its high pretest probability (greater than 40%) for serious intracranial pathology such as subarachnoid hemorrhage. […] A lumbar puncture must follow a normal computed tomography scan to exclude subarachnoid hemorrhage.

• #27 Acute Headache in Adults: A Diagnostic Approach | AAFP

  https://www.aafp.org/pubs/afp/issues/2022/0900/acute-headache-adults.html

  A detailed history and physical examination can distinguish between key features of benign primary headaches and concerning symptoms that warrant further evaluation for a secondary headache. […] Red flag signs or symptoms such as acute thunderclap headache, fever, meningeal irritation on physical examination, papilledema with focal neurologic signs, impaired consciousness, and concern for acute glaucoma warrant immediate evaluation. […] Patients with acute thunderclap headache should be sent to the emergency department and should receive computed tomography of the head within 12 hours of symptom onset. […] Immediate evaluation is necessary for acute thunderclap headache because of its high pretest probability (greater than 40%) for serious intracranial pathology such as subarachnoid hemorrhage. […] A lumbar puncture must follow a normal computed tomography scan to exclude subarachnoid hemorrhage.

• #28 Thunderclap Headaches | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/thunderclap-headaches/

  In some cases, a thunderclap headache may be accompanied by fever, weakness, confusion, loss of vision or sensation, or changes in speech or thinking. If you experience any of these symptoms alongside a thunderclap headache, you should seek immediate medical attention. […] Abrupt, severe headaches triggered by activity—including sexual activity or straining to have a bowel movement—or headaches coming on after an injury have especially high potential to be dangerous. […] There is a broad range of possible injuries and underlying conditions that can result in thunderclap headaches, and the consequences can be severe. […] If a patient is evaluated promptly, the problem can often be diagnosed with a CAT scan and a spinal tap or lumbar puncture, in which a sample of spinal fluid is withdrawn from the back and analyzed for the presence of blood.

• #29 Thunderclap Headache: An Overview – Neurology Advisor

  https://www.neurologyadvisor.com/features/thunderclap-headache-an-overview/

  Although thunderclap headache (TCH) is rare, it can indicate the presence of a serious underlying disorder and thus warrants immediate medical attention. […] The big question is whether this is a primary headache or a secondary headache due to subarachnoid hemorrhage or another serious condition, he told Neurology Advisor. […] This is why people, even those who have already been to the emergency department, had a CT, and had normal neurological examinations, need to be re-evaluated immediately if they develop a new or worse headache, or any new weakness, decreased awareness, speech problems, or unusual symptoms in the days following an injury, according to Dr Tepper. […] Diagnosis of RCVS typically requires immediate magnetic resonance angiography (MRA) or CT angiogram (CTA), as the blood vessels may appear normal after the spasm has resolved.

• #30 Thunderclap headache: when the risk of doing nothing is too high | Medicine Today

  https://medicinetoday.com.au/mt/2017/july/feature-article/thunderclap-headache-when-risk-doing-nothing-too-high

  A thunderclap headache is an uncommon presentation of headache but is important to recognise because it is often associated with serious vascular intracranial disorders, and should therefore be investigated urgently. Aneurysmal subarachnoid haemorrhage is the foremost consideration, and reversible cerebral vasoconstriction the next most common cause. The causes and diagnostic approach to patients with thunderclap headache are discussed. […] The cause of thunderclap headache should be considered to be aneurysmal subarachnoid haemorrhage until proven otherwise. […] Following the history and physical examination, all patients with thunderclap headache should be managed as a medical emergency to avoid potentially catastrophic consequences from SAH and other intracranial causes of the headache.

• #31 Headache Disorders: Differentiating Primary and Secondary Etiologies

  https://www.imrpress.com/journal/JIN/23/2/10.31083/j.jin2302043/htm

  Subarachnoid hemorrhage (SAH) is a life-threatening medical emergency that classically presents within the emergency department and characterized by a thunderclap headache, defined as a severe headache with an acute onset that reaches maximum intensity in less than one minute. […] The presence of acute-onset headaches should prompt at least a consideration of SAH. […] While a thunderclap headache should always prompt a workup, since a wide range of other etiologies can present with a thunderclap headache, additional clues in the clinical history can help narrow the differential diagnosis. […] The most studied decision-making tool is the Ottawa SAH rule which has been prospectively validated. […] The Ottawa SAH Rule had a 100% sensitivity, 13.6–15.3% specificity, and similar neuroimaging rates in subsequent validation studies.

• #32 Thunderclap headache: The “worst headache of my life” – Harvard Health

  https://www.health.harvard.edu/blog/thunderclap-headache-the-worst-headache-of-my-life-2019062516939

  Not all headache disorders are the same. An excruciating, sudden-onset headache known as thunderclap headache (TCH) is a medical emergency, very different from more common headache disorders such as migraine and tension headache. If you develop TCH, you should call 911 or immediately go to the closest hospital. […] Urgent evaluation in an emergency setting is needed to quickly identify and treat any underlying condition. […] When you arrive at the hospital, the medical team will want to confirm or rule out a potentially serious, secondary cause of the TCH. […] A secondary TCH has an underlying cause, other than the headache itself. […] If a secondary cause is identified, the underlying problem will be treated. […] If no obvious cause is found, TCH is considered primary, or idiopathic.

• #33 Thunderclap headache: when the risk of doing nothing is too high | Medicine Today

  https://medicinetoday.com.au/mt/2017/july/feature-article/thunderclap-headache-when-risk-doing-nothing-too-high

  About 70% of patients with SAH present with headaches as the main symptom, and about 50% of these present with thunderclap headache. SAH is found in up to 25% of patients with thunderclap headache. Aneursymal SAH is therefore the diagnosis of foremost consideration in this scenario. […] Treatment of SAH is highly specialised and patients require management in a well-equipped expert neurosurgical unit. Management includes supportive care and avoidance of vasoconstriction, which may produce cerebral ischaemia. The cornerstone of treatment is to prevent further bleeding from the cause (usually an aneurysm). This requires surgical securing of the aneurysm (by clipping) or endovascular treatment (with coils and similar devices). […] A thunderclap headache is an uncommon presentation of headache but is important to recognise because it should prompt urgent medical review and investigation as it is often associated with serious vascular intracranial disorders. Aneurysmal SAH is the foremost consideration. Understanding of RCVS is expanding and this is probably the next most common cause for thunderclap headache.

• #34 Focus on the management of thunderclap headache: from nosography to treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC3072477/

  Once the diagnosis has been defined with certainty, secondary forms of TCH must be managed through treatment of the underlying brain disorder. For primary TCH, as well as for forms associated with RCVS, the therapeutic options are restricted to nimodipine, intravenously or orally administered, although gabapentin was reported effective in one case of primary TCH.

• #35 An unusual cause of thunderclap headache after eating the hottest pepper in the world – “The Carolina Reaper” | BMJ Case Reports

  https://casereports.bmj.com/content/2018/bcr-2017-224085

  A 34-year-old man with no significant medical history presented to the emergency room (ER) after an episode of thunderclap headache. […] A presumptive diagnosis of thunderclap headache secondary to reversible cerebral vasoconstriction syndrome (RCVS) was made based on the clinical presentation of a severe acute headache, exclusion of aneurysmal subarachnoid haemorrhage, and segmental cerebral arterial vasoconstriction on CT angiography. […] RCVS should be considered as a potential cause of thunderclap headache after most common causes are ruled out including subarachnoid haemorrhage, cerebral vein thrombosis, cervical artery dissection, etc. […] The primary treatment for RCVS is removal of the offending agent and supportive care.

• #36 Thunderclap headache: The “worst headache of my life” – Harvard Health

  https://www.health.harvard.edu/blog/thunderclap-headache-the-worst-headache-of-my-life-2019062516939

  Not all headache disorders are the same. An excruciating, sudden-onset headache known as thunderclap headache (TCH) is a medical emergency, very different from more common headache disorders such as migraine and tension headache. If you develop TCH, you should call 911 or immediately go to the closest hospital. […] Urgent evaluation in an emergency setting is needed to quickly identify and treat any underlying condition. […] When you arrive at the hospital, the medical team will want to confirm or rule out a potentially serious, secondary cause of the TCH. […] A secondary TCH has an underlying cause, other than the headache itself. […] If a secondary cause is identified, the underlying problem will be treated. […] If no obvious cause is found, TCH is considered primary, or idiopathic.

• #37 Thunderclap Headaches | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/thunderclap-headaches/

  If doctors find no specific cause after a medical examination, they may then start treatment for what is called primary thunderclap headache, which is considered benign. […] If these headaches occur predictably at certain times, such as with sexual activity, then treating them with medication such as a non-steroidal anti-inflammatory (NSAID)—in particular, indomethacin—may be all that is needed. […] It is difficult to know whether or not a sudden, severe headache is a sign of a dangerous underlying condition. For this reason, all first-time thunderclap headaches should be dealt with by seeking immediate medical evaluation to look for signs of more serious problems.

• #38 Thunderclap Headache: Symptoms, Causes, and Treatment

  https://www.verywellhealth.com/thunderclap-headache-7101082

  A thunderclap headache strikes suddenly, causing severe, explosive head pain that rapidly peaks in intensity within one minute and lasts at least five minutes. […] This article will review the symptoms, causes, diagnosis, and treatment of a thunderclap headache. It will also explain why a thunderclap headache is a medical emergency that’s almost always considered dangerous. […] Individuals with a thunderclap headache often describe it as the worst headache they have ever experienced. The headache is excruciatingly painful and begins abruptly and unexpectedly, like a clap of thunder. […] The treatment of a thunderclap headache depends on whether it’s a primary or secondary headache. […] A primary thunderclap headache is treated with a nonsteroidal anti-inflammatory drug (NSAID), commonly Indocin (indomethacin).

• #39 Thunderclap headache: The “worst headache of my life” – Harvard Health

  https://www.health.harvard.edu/blog/thunderclap-headache-the-worst-headache-of-my-life-2019062516939

  Primary TCH typically affects young adults. […] There is no known preventive medication for primary TCH or RCVS. […] Bed rest is recommended, since exercise, anxiety, and sexual activity can precipitate more TCHs. […] The extreme head pain usually settles in a few minutes, but moderate to severe headache can persist for several hours. […] Certain medications should not be used to treat TCH. […] Primary TCH can recur intermittently for several years. […] The extreme head pain of primary TCH and RCVS can understandably evoke significant anxiety. But the long-term outcome is nearly always benign.

• #40 Thunderclap Headaches: Definition, Symptoms, Treatments

  https://resources.healthgrades.com/right-care/migraine-and-headache/thunderclap-headaches

  Thunderclap headaches (TCH) are sudden, severe headaches. Pain can peak within 30 seconds to 1 minute after the headache begins. […] A secondary TCH typically results from an intracranial vascular disorder. In rare cases, a primary TCH can occur when there is no underlying condition for the headache. […] The main symptom of a thunderclap headache (TCH) is the abrupt onset of severe, explosive headache pain. It worsens within a few minutes and can last anywhere from 5 minutes to a few hours. […] Treatments for a thunderclap headache (TCH) include calcium channel blockers, such as nimodipine, nonsteroidal anti-inflammatory drugs and other pain relievers, acetaminophen, beta-blockers, topiramate and lithium in lower dosages. […] If you experience a secondary TCH, you will require treatment for the underlying cause. Your doctor can explain what treatment options are available to you, depending on the condition. […] It is important to receive treatment for a thunderclap headache (TCH) as soon as you experience it, as some causes of TCH can be life threatening. […] It is important to contact your doctor as soon as you experience a TCH. Medical professionals usually treat this condition as an emergency.

• #41 Thunderclap Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560629/

  Patients presenting with a thunderclap headache (TCH) may describe their pain as the worst headache ever or worst headache of my life. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency, requiring a rapid, focused evaluation. […] A focused history and neurologic examination will help differentiate TCH from other headache types, narrow the secondary TCH differential diagnoses, and guide the initial testing phase. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency. […] The absence of associated symptoms and a normal physical examination do not exclude a serious etiology of secondary TCH. […] Managing patients presenting with TCH requires an interprofessional team of clinicians, including physicians, physician assistants, nurses, nurse practitioners, pharmacists, and ancillary staff. […] Nurses play a valuable role in coordinating activities among the various clinicians on the case, ensuring the patient is informed about the latest developments. […] This interprofessional paradigm will result in the best patient outcomes with the fewest adverse events.

• #42 Unraveling a Thunderclap Headache in a Young Adult With SAH – Clinical Advisor

  https://www.clinicaladvisor.com/features/unraveling-a-thunderclap-headache-in-a-young-adult-with-sah/

  A 23-year-old woman presents to the emergency department (ED) with a sudden onset of a thunderclap headache that she describes as the worst headache of her life. […] Patients with SAH typically experience a sudden, severe headache, often described as a thunderclap or the worst headache of their life, which is a hallmark symptom of the condition. […] The primary goal in SAH management is directed toward preventing neurological and systemic complications. […] Nurse practitioners (NPs) facilitate an interprofessional approach, ensuring timely interventions and closely monitoring the patient for complications. […] APPs are pivotal in the initial recognition of SAH, offering ongoing neurologic assessments, medication management, and patient education. […] Patients need comprehensive support systems after SAH, including psychiatric referrals, cognitive behavioral therapy, and neuropsychologic evaluations.

• #43 Unraveling a Thunderclap Headache in a Young Adult With SAH – Clinical Advisor

  https://www.clinicaladvisor.com/features/unraveling-a-thunderclap-headache-in-a-young-adult-with-sah/

  Effective pain management is also crucial for patient comfort and to prevent secondary complications, with careful attention to avoid oversedation, which can mask neurologic changes. […] The long-term management of patients recovering from SAH involves addressing mental health challenges, which are common and often persistent.

• #44 Thunderclap Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560629/

  Patients presenting with a thunderclap headache (TCH) may describe their pain as the worst headache ever or worst headache of my life. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency, requiring a rapid, focused evaluation. […] A focused history and neurologic examination will help differentiate TCH from other headache types, narrow the secondary TCH differential diagnoses, and guide the initial testing phase. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency. […] The absence of associated symptoms and a normal physical examination do not exclude a serious etiology of secondary TCH. […] Managing patients presenting with TCH requires an interprofessional team of clinicians, including physicians, physician assistants, nurses, nurse practitioners, pharmacists, and ancillary staff. […] Nurses play a valuable role in coordinating activities among the various clinicians on the case, ensuring the patient is informed about the latest developments. […] This interprofessional paradigm will result in the best patient outcomes with the fewest adverse events.

• #45

  https://continentalhospitals.com/diseases/thunderclap-headaches/

  Patient Education: Informing patients about the signs, symptoms, and potential triggers of thunderclap headaches to ensure prompt future action. […] When it comes to thunderclap headaches, knowing the do’s and don’ts can make a significant difference in managing and preventing these intense and sudden headaches.

• #46 Thunderclap headache: The “worst headache of my life” – Harvard Health

  https://www.health.harvard.edu/blog/thunderclap-headache-the-worst-headache-of-my-life-2019062516939

  Primary TCH typically affects young adults. […] There is no known preventive medication for primary TCH or RCVS. […] Bed rest is recommended, since exercise, anxiety, and sexual activity can precipitate more TCHs. […] The extreme head pain usually settles in a few minutes, but moderate to severe headache can persist for several hours. […] Certain medications should not be used to treat TCH. […] Primary TCH can recur intermittently for several years. […] The extreme head pain of primary TCH and RCVS can understandably evoke significant anxiety. But the long-term outcome is nearly always benign.

• #47 Thunderclap Headache (Severe Sudden Headache) – MD Searchlight

  https://mdsearchlight.com/migraine-headaches/thunderclap-headache-severe-sudden-headache/

  The prognosis for Thunderclap Headache (Severe Sudden Headache) can vary depending on the underlying cause. In cases where it is caused by a subarachnoid hemorrhage (SAH), the mortality rate can be high, with 10 to 18% of people passing away before reaching the hospital and the mortality rate increasing to 35 to 65% within a year. However, for patients with Reversible Cerebral Vasoconstriction Syndrome (RCVS), more than 90% tend to have excellent long-term outcomes.

• #48 Thunderclap Headache (Severe Sudden Headache) – MD Searchlight

  https://mdsearchlight.com/migraine-headaches/thunderclap-headache-severe-sudden-headache/

  The prognosis for Thunderclap Headache (Severe Sudden Headache) can vary depending on the underlying cause. In cases where it is caused by a subarachnoid hemorrhage (SAH), the mortality rate can be high, with 10 to 18% of people passing away before reaching the hospital and the mortality rate increasing to 35 to 65% within a year. However, for patients with Reversible Cerebral Vasoconstriction Syndrome (RCVS), more than 90% tend to have excellent long-term outcomes.

• #49 Thunderclap headache: The “worst headache of my life” – Harvard Health

  https://www.health.harvard.edu/blog/thunderclap-headache-the-worst-headache-of-my-life-2019062516939

  Primary TCH typically affects young adults. […] There is no known preventive medication for primary TCH or RCVS. […] Bed rest is recommended, since exercise, anxiety, and sexual activity can precipitate more TCHs. […] The extreme head pain usually settles in a few minutes, but moderate to severe headache can persist for several hours. […] Certain medications should not be used to treat TCH. […] Primary TCH can recur intermittently for several years. […] The extreme head pain of primary TCH and RCVS can understandably evoke significant anxiety. But the long-term outcome is nearly always benign.

• #50 Is Thunderclap Headache Dangerous? Should I Rush to the ER? – Migraine Buddy

  https://migrainebuddy.com/is-thunderclap-headache-dangerous-should-i-rush-to-the-er/

  Thunderclap headaches are sudden and severe headaches that have been described as feeling like a “bolt from the blue.” Due to their intensity and abrupt onset, there is often a fear of a dangerous underlying condition. Understanding the potential dangers associated with thunderclap headaches is crucial in determining whether immediate medical attention is necessary. […] Thunderclap headaches can be an indication of life-threatening conditions such as subarachnoid hemorrhage (SAH) or cerebral venous sinus thrombosis (CVST). These conditions require immediate medical attention to prevent serious complications. Delayed diagnosis and treatment can increase the risk of permanent damage or even death. […] Thunderclap headaches should be taken seriously due to the potential dangers they may indicate. However, whether you should rush to the emergency room depends on various factors, including the presence of alarming symptoms and signs, personal history, and medical advice. Erring on the side of caution is important when in doubt about the severity of your thunderclap headache.

• #51 Thunderclap Headache: What It Is, Causes & Symptoms

  https://my.clevelandclinic.org/health/symptoms/17876-thunderclap-headaches

  A thunderclap headache is a rare type of headache thats extremely painful and comes on suddenly. It can be a sign of blood vessel issues or bleeding in your brain. Because of this, a thunderclap headache requires immediate medical attention. […] Its important to seek medical attention immediately to rule out life-threatening causes of a thunderclap headache. […] Thunderclap headaches are a medical emergency, and its 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. […] Go to the emergency room if youre experiencing a thunderclap headache for the first time. Its 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. […] A healthcare provider will order tests to determine if a more serious medical condition is causing it.

• #52 Thunderclap Headaches: Symptoms, Causes, and Treatment

  https://www.healthline.com/health/thunderclap-headaches

  A thunderclap headache is a severe headache that starts suddenly. It doesnt gradually build in intensity. Instead, its an intense and very painful headache as soon as it starts. It can be a sign of a condition that can be life threatening. […] Its important that you seek medical attention if you think youre experiencing one. It may also have a benign cause thats not life threatening, but a doctor should still check it immediately to find out whats causing it. […] You should seek medical help immediately when you first experience a severe and sudden headache of any kind. This type of headache can be a sign or symptom of a life threatening condition. […] If you seek medical help immediately when you experience a thunderclap headache, the cause can usually be effectively treated or managed. However, delaying medical treatment could be fatal. […] You should seek medical attention immediately if you experience a thunderclap headache, as its considered a medical emergency and may be a sign of a more serious underlying issue.

• #53 Thunderclap headaches – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/thunderclap-headaches/symptoms-causes/syc-20378361

  Thunderclap headaches care at Mayo Clinic […] Seek emergency medical attention for a thunderclap headache. […] Seek immediate medical attention for any headache that comes on suddenly and severely.

• #54 Thunderclap Headaches: Symptoms, Causes, and Treatment

  https://www.healthline.com/health/thunderclap-headaches

  A thunderclap headache is a severe headache that starts suddenly. It doesnt gradually build in intensity. Instead, its an intense and very painful headache as soon as it starts. It can be a sign of a condition that can be life threatening. […] Its important that you seek medical attention if you think youre experiencing one. It may also have a benign cause thats not life threatening, but a doctor should still check it immediately to find out whats causing it. […] You should seek medical help immediately when you first experience a severe and sudden headache of any kind. This type of headache can be a sign or symptom of a life threatening condition. […] If you seek medical help immediately when you experience a thunderclap headache, the cause can usually be effectively treated or managed. However, delaying medical treatment could be fatal. […] You should seek medical attention immediately if you experience a thunderclap headache, as its considered a medical emergency and may be a sign of a more serious underlying issue.

• #55 Thunderclap Headaches | American Migraine Foundation

  https://americanmigrainefoundation.org/resource-library/thunderclap-headaches/

  If doctors find no specific cause after a medical examination, they may then start treatment for what is called primary thunderclap headache, which is considered benign. […] If these headaches occur predictably at certain times, such as with sexual activity, then treating them with medication such as a non-steroidal anti-inflammatory (NSAID)—in particular, indomethacin—may be all that is needed. […] It is difficult to know whether or not a sudden, severe headache is a sign of a dangerous underlying condition. For this reason, all first-time thunderclap headaches should be dealt with by seeking immediate medical evaluation to look for signs of more serious problems.

• #56 Thunderclap Headache: What It Is, Causes & Symptoms

  https://my.clevelandclinic.org/health/symptoms/17876-thunderclap-headaches

  A thunderclap headache is a rare type of headache thats extremely painful and comes on suddenly. It can be a sign of blood vessel issues or bleeding in your brain. Because of this, a thunderclap headache requires immediate medical attention. […] Its important to seek medical attention immediately to rule out life-threatening causes of a thunderclap headache. […] Thunderclap headaches are a medical emergency, and its 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. […] Go to the emergency room if youre experiencing a thunderclap headache for the first time. Its 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. […] A healthcare provider will order tests to determine if a more serious medical condition is causing it.

• #57 Thunderclap Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560629/

  Patients presenting with a thunderclap headache (TCH) may describe their pain as the worst headache ever or worst headache of my life. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency, requiring a rapid, focused evaluation. […] A focused history and neurologic examination will help differentiate TCH from other headache types, narrow the secondary TCH differential diagnoses, and guide the initial testing phase. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency. […] The absence of associated symptoms and a normal physical examination do not exclude a serious etiology of secondary TCH. […] Managing patients presenting with TCH requires an interprofessional team of clinicians, including physicians, physician assistants, nurses, nurse practitioners, pharmacists, and ancillary staff. […] Nurses play a valuable role in coordinating activities among the various clinicians on the case, ensuring the patient is informed about the latest developments. […] This interprofessional paradigm will result in the best patient outcomes with the fewest adverse events.

• #58 Thunderclap Headache – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560629/

  Patients presenting with a thunderclap headache (TCH) may describe their pain as the worst headache ever or worst headache of my life. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency, requiring a rapid, focused evaluation. […] A focused history and neurologic examination will help differentiate TCH from other headache types, narrow the secondary TCH differential diagnoses, and guide the initial testing phase. […] TCH is often associated with a potentially fatal etiology, such as subarachnoid hemorrhage (SAH), and is considered a medical emergency. […] The absence of associated symptoms and a normal physical examination do not exclude a serious etiology of secondary TCH. […] Managing patients presenting with TCH requires an interprofessional team of clinicians, including physicians, physician assistants, nurses, nurse practitioners, pharmacists, and ancillary staff. […] Nurses play a valuable role in coordinating activities among the various clinicians on the case, ensuring the patient is informed about the latest developments. […] This interprofessional paradigm will result in the best patient outcomes with the fewest adverse events.

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