Thunderclap Headache: Signs of an Aneurysm or Stroke

Most headaches build slowly, and you can usually tell where they came from. A thunderclap headache feels different. The pain explodes out of nowhere and reaches full strength in seconds. Many people describe it as the worst headache of their life. Studies show a thunderclap headache reaches its peak within one minute. The most common serious cause is a subarachnoid hemorrhage, a type of bleeding around the brain that usually comes from a ruptured aneurysm. 

Read on to learn what headache symptoms need emergency care and what to look for if you need the best brain aneurysm treatment in Santa Barbara after you are discharged from the emergency room.

What Does a Thunderclap Headache Feel Like?

A thunderclap headache hits suddenly and with full force. It can strike during exercise, heavy lifting, straining, or even at rest. Some people feel a pop or snap in the head right before the pain starts. Even if you have a history of migraines, a headache that peaks this quickly needs an emergency evaluation. Call 911 and let paramedics take you to the nearest hospital.

Warning Signs That You Need to Get Emergency Care for a Headache

A sudden, severe headache becomes even more urgent when it comes with any of these symptoms:

• A stiff or painful neck
• Nausea or vomiting
• Sensitivity to light
• Blurred or double vision
• A drooping eyelid
• Confusion, fainting, or trouble staying awake
• Weakness or numbness on one side of the body
• A seizure

What Can Cause a Sudden, Severe Headache?

A ruptured aneurysm is the first cause doctors rule out, but several other brain and blood vessel problems can feel the same way: 

What to Expect When You Seek Emergency Care for a Severe Headache

Speed matters because a brain bleed can quickly cause lasting damage. Your emergency team will likely follow these steps:

• A CT scan of the head to look for bleeding
• A lumbar puncture if the CT scan looks normal, which checks the spinal fluid for traces of blood
• A CT angiogram, MR angiogram, or cerebral angiogram to examine the blood vessels in the brain and neck
• An MRI of the brain if earlier tests do not explain the headache

What Happens If a Ruptured Aneurysm Is Found?

When tests confirm a ruptured aneurysm, the first goal is to seal it quickly so it cannot bleed again. Neuroendovascular specialists in California can do this from inside the blood vessels by guiding a catheter to the aneurysm and filling it with soft platinum coils or blocking it with a flow-diverting device.

After treatment, patients usually stay in an intensive care unit for close monitoring. During this time, the care team watches for vasospasm, a narrowing of brain arteries that can develop in the days after a bleed, and manages pressure from fluid around the brain.

What If a Scan Finds an Unruptured Aneurysm?

Sometimes imaging shows no bleeding but finds a small aneurysm that has not burst. Hearing that news can feel frightening, yet many unruptured aneurysms can be monitored or treated before they cause harm. If this is the case, your specialist will weigh the aneurysm's size, location, shape, and growth along with risk factors including smoking, high blood pressure, and family history. Treatment options may include:

• Repeat imaging to watch for changes over time
• Coil embolization, which fills the aneurysm from inside through a catheter
• A flow diverter, a fine mesh stent that steers blood away from the aneurysm so it can seal off
• Stent-assisted coiling for wide or complex aneurysms

Most of these procedures can help you avoid open brain surgery. Quitting smoking and controlling your blood pressure also lower the chance that an aneurysm will grow.

Searching for the Best Stroke Treatment in Santa Barbara?

Our Santa Barbara team at the Vascular and Neuroscience Institute includes Dr. Hisham Salahuddin, a board-certified neurologist, vascular neurologist, and neuroendovascular specialist. He directs the Comprehensive Stroke Program at Antelope Valley Hospital, has performed more than 1,500 endovascular procedures over a two-year span, and has also published research on clot removal techniques and intracranial aneurysm treatment. He makes himself available for acute stroke consultations any day of the week.

At the Vascular and Neuroscience Institute, our multidisciplinary team offers coil embolization, flow diversion, and stent-assisted brain aneurysm embolization.

If you or a loved one needs follow-up care after an ER visit and wants the best brain aneurysm treatment in Santa Barbara, visit our Santa Barbara office near the Presidio for a thorough evaluation.