Thunderclap headaches 

Diagnosis  

The following diagnostic methods are commonly employed to identify the underlying cause of a sudden and severe thunderclap headache: 

• Head Computed Tomography (CT) Scan: This procedure involves using X–rays to generate cross–sectional images of the brain and head. A computer combines these images to create a comprehensive view of the brain. Sometimes, a contrast dye containing iodine may be administered to enhance the images. 
• Lumbar Puncture (Spinal Tap): During this procedure, a small amount of cerebrospinal fluid surrounding the brain and spinal cord is extracted. The collected cerebrospinal fluid sample can be analyzed for indications of bleeding or infection. 
• Magnetic Resonance Imaging (MRI): In certain cases, an MRI is conducted for more detailed assessment. This technique employs a magnetic field and radio waves to produce cross–sectional images of the brain’s internal structures. 
• Magnetic Resonance Angiography (MRA): Utilizing MRI technology, this test allows for the visualization of blood flow within the brain’s vessels. It assists in mapping the patterns of blood circulation. 

Treatment 

Thunderclap headaches represent a medical urgency, demanding a thorough evaluation to identify their root cause. Healthcare professionals, upon identifying the cause, customize the treatment approach accordingly. In cases where torn or ruptured blood vessels are the issue, surgical intervention might be necessary for resolution. Treatment selection will be guided by the specific cause of the thunderclap headache. 

For instances where no immediate underlying condition is apparent (termed primary thunderclap headache), medical practitioners may opt for medication as a remedy. Nonsteroidal anti–inflammatory drugs (NSAIDs) can be employed to alleviate inflammation and reduce discomfort.