Overview
Diagnosis
To determine the cause of a thunderclap headache, your healthcare professional may recommend several tests.
CT scan of the head
CT scans take X-rays to create slice-like, cross-sectional images of the brain and head. A computer combines these images to form a full picture. Sometimes an iodine-based dye is used to enhance the images.
Spinal tap (lumbar puncture)
A small amount of cerebrospinal fluid, which surrounds the brain and spinal cord, is removed. The fluid is tested for signs of bleeding or infection.
MRI
Magnetic resonance imaging uses radio waves and a magnetic field to create cross-sectional images of the structures within the brain. This test may be done for further assessment.
Magnetic resonance angiography (MRA)
An MRI machine can map blood flow in the brain, helping identify vascular causes of thunderclap headaches.
Treatment
Treatment focuses on addressing the underlying cause of the headache if it can be identified.
Thunderclap headaches are often evaluated in an emergency setting. If you see your own doctor, you may be referred to a neurologist who specializes in brain and nervous system disorders.
Preparing for your appointment
• Make a list of your symptoms, including when they began and any seemingly unrelated issues.
• Include key personal information, such as major stresses, recent life changes, and medical history.
• List all medications, vitamins, and supplements you take, including doses.
• Bring a family member or friend to help remember the information you receive.
Questions to ask your doctor
• What is likely causing my headaches?
• Are there other possible causes?
• What tests do I need?
• Is my condition likely temporary or chronic?
• What is the best course of action?
• How should I manage these headaches alongside other health conditions?
• Are there any restrictions I need to follow?
• Should I see a specialist?
• Are there brochures or websites you recommend for more information?
What to expect from your doctor
Your doctor may ask questions about:
• Previous thunderclap headaches
• History of other headaches
• Frequency and pattern of past headaches
• Description and severity of current headaches
• Factors that improve or worsen your headaches
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