Thunderclap headache causes
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Thunderclap Headache Causes: Key Medical Conditions
Thunderclap headache (TCH) is a sudden, severe headache that reaches its peak intensity within one minute. It is considered a medical emergency because it can be a sign of serious underlying conditions. The most important and common causes are outlined below.
Subarachnoid Hemorrhage and Aneurysmal Bleeding
The most critical and frequently identified cause of thunderclap headache is subarachnoid hemorrhage, often due to a ruptured cerebral aneurysm. This condition is life-threatening and requires immediate medical attention 12345710.
Reversible Cerebral Vasoconstriction Syndrome (RCVS)
RCVS is now recognized as a leading cause of thunderclap headache, especially in patients without subarachnoid hemorrhage. RCVS is characterized by sudden, severe headaches that may recur over days or weeks and can be triggered by exertion, sexual activity, emotional stress, or bathing. RCVS can sometimes lead to stroke or other complications if not diagnosed early 123458910.
Vascular Disorders: Arterial Dissection and Cerebral Venous Sinus Thrombosis
Other vascular causes include cervical artery dissection and cerebral venous sinus thrombosis. Both conditions can present with thunderclap headache and may have serious neurological consequences if not promptly treated 12345710.
Intracranial Hemorrhage and Ischemic Stroke
Thunderclap headache can also be caused by other types of intracranial hemorrhage (such as intracerebral or retroclival hematoma) and by ischemic stroke. These conditions are less common but still important to consider 12345710.
Spontaneous Intracranial Hypotension
A sudden drop in cerebrospinal fluid pressure, known as spontaneous intracranial hypotension, can also trigger thunderclap headache. This may occur after a spinal fluid leak 1234510.
Pituitary Apoplexy
Pituitary apoplexy, a sudden hemorrhage or infarction of the pituitary gland, is a rare but notable cause of thunderclap headache. Early diagnosis is crucial to prevent serious complications 12345610.
Colloid Cyst and Other Structural Lesions
A colloid cyst in the third ventricle of the brain can block cerebrospinal fluid flow, leading to a sudden and severe headache. Other structural brain lesions, such as tumors or cysts, may also present with thunderclap headache 1234510.
Intracranial Infections
Severe infections of the brain, such as meningitis or encephalitis, can sometimes present with a thunderclap headache as an initial symptom 1234510.
Primary Thunderclap Headache and Other Rare Causes
In some cases, no underlying cause is found, and the diagnosis is primary thunderclap headache. However, this is a diagnosis of exclusion after thorough investigation. Other rare causes include acute hypertensive crisis, unruptured intracranial aneurysm, and pneumocephalus 345710.
Conclusion
Thunderclap headache is a symptom with a wide range of possible causes, many of which are serious and require urgent evaluation. The most common and dangerous cause is subarachnoid hemorrhage, but reversible cerebral vasoconstriction syndrome, vascular disorders, intracranial hemorrhage, pituitary apoplexy, and other structural or infectious conditions must also be considered. Prompt diagnosis and treatment are essential to reduce the risk of complications and improve outcomes 12345789+1 MORE.
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