Thunder clubbing headaches indicate very serious pathological injuries such as bleeding outside and inside the brain and are actually known as the worst type of headache during a person's life, the pain of which is felt in any part of the body such as the head, neck, or even the back. Thunder clubbing usually reaches its maximum intensity after about sixty seconds and lasts up to five minutes, and it is one headache case out of every 100 clinical visits. It is secondary, that is, it is a symptom of a disease. Thunderclap headaches are usually not common and in developed countries, less than 50 cases per hundred thousand adults have been reported.. Among the symptoms of this type of headache are impaired vision and speech along with nausea and vomiting, numbness, suddenness, and intensity... Also, these headaches can be accompanied by seizures, fever, and changes in mental status... Usually, the pain reaches its maximum within 1 minute.... If you see symptoms of lightning, see a head specialist immediately What is a thunderclap headache? Thunderclap headache (TCH) is often caused by damage to brain tissue. One of the most common and important causes is subarachnoid hemorrhage (SAH). This type of bleeding occurs in the space around the brain and requires immediate medical attention. In addition to SAH, other factors can also cause thunderclap headaches, including: - **Intracranial bleeding and blood clots in the brain vessels:** This condition means bleeding inside the brain and the formation of clots in the large vessels of the brain (venous sinus)... - **Inflammation of the brain membrane and tissue (Meningitis):** Infection or inflammation of the membranes covering the brain and spinal cord or the brain tissue itself can cause this type of headache... - **Cerebral vasodilation (Aneurysm): ** Aneurysm means weakness in the blood wall and bulging of the vessels.. Bleeding... - ** Ischemic attacks (sudden reduction of blood):** When blood does not reach a part of the brain in sufficient quantity, ischemic attacks occur which can lead to TCH. It can cause headaches.. Types of, in some cases, sexual activity, sudden exposure to cold or hot water, for example, at the beginning of showering and very intense physical activities can also cause these headaches. Migraine and thunderclap headaches are usually not the same, but most of those who experience this type of headache have had migraine attacks before. Doctors use imaging methods and special tests to diagnose the cause of a thunderclap headache that starts suddenly and very strongly. These measures To identify possible causes of pain in the blood vessels inside and outside the brain, the following tests are performed: - **Cerebral CT scan (CTA):** In the first step, a CT scan of cerebral vessels (CT angiography or CTA) is usually performed... This method helps the doctor to check the condition of the blood vessels inside and outside the brain and to diagnose the cause of the pain... - **MRI and MRA of the brain:** - **MRI:** The doctor may use MRI to view the internal structure of the brain and identify any abnormalities... - **MRA:** In some cases, MRI (Magnetic Resonance Angiography or MRA) is used to check the blood flow in the brain vessels and diagnose vascular problems... - **Lumbar tap or spinal tap:** In this method, a sample of the patient's cerebrospinal fluid (CSF) is taken. The patient's spinal cord is taken.. blood or other abnormalities... blood in the CSF can be a sign of cerebral hemorrhage.. thunderclap headache Thunderclap headache treatment depends entirely on its root cause, because this type of headache is usually a symptom of a more serious underlying problem. The main goal of the doctor is to eliminate the underlying problem. What treatment method the doctor chooses depends entirely on his diagnosis and the specific condition of the patient. To reduce intracranial pressure. Thunderclap headaches that start suddenly and with high intensity can have various reasons. - **Treatment of cerebral vascular spasm** If your thunderclap headache is caused by a spasm or sudden contraction of cerebral vessels, your doctor may prescribe nimodipine... This medicine helps to relax blood vessels by blocking calcium channels, thus relieving spasm and reducing pain.... - **Surgery is required** In some cases, the cause of Thunderclap headache is more serious and requires surgical intervention... These cases include blood vessel rupture (such as brain aneurysm) or severe blockage of the vessels... In such cases, surgery is necessary to repair the damaged vessel or open the blood flow path... The decision to perform surgery depends on the general condition of the patient and the injury.. **I suggest you read:** Immediate treatment of severe headache Risk factors for thunderclap headache Several factors can increase the risk of developing a thunderclap headache... this sudden and severe headache that reaches its peak within a few seconds. The most important risk factors are: - **Family history:** People who have a family history of disorders such as the tendency to form blood clots are more at risk. In fact, these headaches are sudden and since they usually have not happened to a person in the past, they can be prevented, but the risk of them can be reduced by modifying daily activities. Here are some of them: - Having a healthy diet - Appropriate and regular physical activity - Blood pressure and cholesterol control - Quit smoking The above are among the factors that lead to having healthy veins and controlling the predisposing factors of this type of headache. https://my.clevelandclinic.org/health/diseases/17876-thunderclap-headaches https://www.mayoclinic.org/diseases-conditions/thunderclap-headaches/symptoms-causes/syc-20378361 https://www.healthline.com/health/thunderclap-headaches https://www.webmd.com/migraines-headaches/thunderclap-headaches https://www.health.harvard.edu/blog/thunderclap-headache-the-wsest-headache-of-my-life-2019062516939