THUNDERCLAP HEADACHE

Course overview

PATIENTS PRESENTING WITH A THUNDERCLAP HEADACHE (TCH) MAY DESCRIBE THEIR PAIN AS “THE WORST HEADACHE EVER” OR “WORST HEADACHE OF MY LIFE.” WHAT DIFFERENTIATES TCHS FROM OTHER HEADACHE TYPES IS HOW RAPIDLY THEY REACH THEIR PEAK INTENSITY, NOT THE HEADACHE INTENSITY ITSELF. TCH IS OFTEN ASSOCIATED WITH A POTENTIALLY FATAL ETIOLOGY, SUCH AS SUBARACHNOID HEMORRHAGE (SAH), AND IS CONSIDERED A MEDICAL EMERGENCY, REQUIRING A RAPID, FOCUSED EVALUATION. ACCORDING TO THE ICHD-3, “EVIDENCE THAT THUNDERCLAP HEADACHE EXISTS AS A PRIMARY DISORDER IS POOR: THE SEARCH FOR AN UNDERLYING CAUSE SHOULD BE BOTH EXPEDITED AND EXHAUSTIVE.” THIS ACTIVITY REVIEWS THE CLINICAL PRESENTATION AND RECOMMENDED WORKUP OF PATIENTS WHO PRESENT WITH TCH AND HIGHLIGHTS THE ROLE OF THE INTERPROFESSIONAL TEAM IN PROMPT AND TIMELY RECOGNITION AND MANAGEMENT TO IMPROVE OUTCOMES.