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Tests and diagnosis
By Mayo Clinic staffThe following tests are commonly used to determine if any underlying condition is causing thunderclap headaches.
CT scan
Testing often starts with a computerized tomography (CT) scan of the head to search for an underlying cause of the headache. CT scans take X-rays that create slice-like, cross-sectional images of your brain and head. A computer combines these images to create a full picture of your brain. Sometimes an iodine-based dye is used to augment the picture.
Spinal tap
Sometimes a spinal tap (lumbar puncture) may be needed as well. With this procedure, the doctor removes a small amount of the fluid that surrounds your brain and spinal cord. The cerebrospinal fluid sample can be tested for signs of bleeding or infection.
MRI
In some cases, magnetic resonance imaging (MRI) may be done for further assessment. With this imaging study, a magnetic field and radio waves are used to create cross-sectional images of the structures within your brain.
Magnetic resonance angiography
MRI machines can also be used to map the blood flow inside your brain in a test called a magnetic resonance angiography (MRA).
- Olesen J, et al. The international classification of headache disorders. International Headache Society. http://ihs-classification.org/en/02_klassifikation/02_teil1/04.06.00_other.html. Accessed Oct. 19, 2011.
- Approach to the patient with headache. The Merck Manuals: The Merck Manual for Healthcare Professionals. http://www.merckmanuals.com/professional/neurologic_disorders/headache/approach_to_the_patient_with_headache.html. Accessed Oct. 23, 2011.
- Goadsby PJ, et al. Headache. In: Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies, Inc. 2011. http://www.accessmedicine.com/content.aspx?aID=9094791. Accessed Oct. 23, 2011.
- Headache: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/headache/detail_headache.htm. Accessed Oct. 23, 2011.
- DuPont SA, et al. Thunderclap headache and normal computed tomographic results: Value of cerebrospinal fluid analysis. Mayo Clinic Proceedings. 2008;83:1326.
- Savitz SI, et al. Thunderclap headache with normal CT and lumbar puncture: Further investigations are unnecessary: For. Stroke. 2008;39:1392.
- Tarshish S, et al. Teaching case presentation: Primary thunderclap headache. Headache. 2009;49:1249.
- Mistry N, et al. Thunderclap headache. Practical Neurology. 2009;9:294.
- Neurological diagnostic tests and procedures. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/misc/diagnostic_tests.htm. Accessed Oct. 23, 2011.
- Headache Classification Subcommittee of the International Headache Society. The international classification of headache disorders: 2nd ed. Cephalalgia. 2004;24(suppl):9.
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