Discussions By Condition: I cannot get a diagnosis.

Prolonged Thunderclap Headache

Posted In: I cannot get a diagnosis. 12 Replies
  • Posted By: johnnyboy
  • June 29, 2007
  • 06:14 PM

Hi - I wonder if anyone can help diagnose what might be causing my intense, persistent headache?

Almost 5 days ago whilst walking along a corridor I suddenly got struck by the worst headache I've ever had. It came on in a single heartbeat and was immediately agonising. It was an intense throbbing that all but debilitated me and I had to go to bed. I was unable to get comfortable, even with pain killers - the only thing that even slightly alleviated the pain was standing up which slightly reduced the pressure in my head.

The pain was evenly distributed around my head and was entirely pulse-based - i.e. it throbbed, and in between heartbeats there was no pain.

After putting up with it for around 30 hours, I went to A&E (ER) and was admitted for a CT scan and then a lumbar puncture. I was kept in over night but both tests proved negative for bleeding and I was released with painkillers, and no diagnosis of what might be wrong - other than being reassured that I don't have a SAH or a tumour.

I went to my GP the next day and he prescribed more painkillers and told me to take a week off work - suggesting that it might be stress related.

Since then (I am now on day 5) the general pain has abated to about half the level it was at the beginning, and seems to now be focussed in the right hemisphere near my ear & eye.

However, if I do anything that even slightly raises my blood pressure (such as bending down, or walking up stairs) the throbbing instantly kicks in and
then spreads across my whole head. I take Co-Dydromol and Ibuprofen every 4 hours and this mostly keeps the pain at bay, but I wake up in the middle of the night when the pain killers wear off.


I have no other symptoms - no neurolical deficit, no fever etc.

From what I've read this doesn't seem to fit the profile of a stress-related headache - although I admit I am under a certain amount of stress at the moment. I do not normally suffer from headaches even when stressed, and have never had anything close to this level of pain or duration of pain from a headache before.


Does anyone have any ideas what might be going on, or any suggestions for what I should do next?


Thanks for any help anyone can give me.

Best regards,
John.

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12 Replies:

  • cluster migraine headache.
    rad-skw 1605 Replies Flag this Response
  • cluster migraine headache.Thanks rad_skw but from what I've read Cluster headaches typically last no more than a couple of hours, whereas mine has been continual for what is now 6 days :mad:
    johnnyboy 5 Replies Flag this Response
  • Cluster headaches can last on and off for years sorry to say. Try alternative treatment such as Acupuncture, Chiropractic manipulation may help if you have any spine issues, Aromatherapy to help you relax. Have your sinuses checked to make sure this isn't making things worse.
    Anonymous 42789 Replies Flag this Response
  • Cluster headaches can last on and off for years sorry to say. Try alternative treatment such as Acupuncture, Chiropractic manipulation may help if you have any spine issues, Aromatherapy to help you relax. Have your sinuses checked to make sure this isn't making things worse.Midge, just to be clear, are you saying that a cluster headache can give you intense throbbing pain continually for 6 days without any respite?My understanding was that individual cluster headache attacks could last from minutes up to 4 hours, then disappear and come back again later. That's not what I have - I have continuous pain, which is why when I researched the possible types of headaches I did not think my symptoms match a cluster headache?
    johnnyboy 5 Replies Flag this Response
  • I had a similar thing happened to me in 2006. The pain stayed about where you said, around my eye and temple area. However, I also had light sensitivity and nausea which developed over time.The final diagnosis for me wasn't made until I saw 1 neurologist, 1 ENT, 2 primary doctors, 2 ER doctors, 2 CT Scans and 1 MRI. Everybody but the last ER doctor got it wrong. The final ER doctor diagnosed me with an Acute Narrow-Angle Glaucoma Attack. By that time I had nausea, vomiting, and diarrhea and weight loss for 2 months, on and off headaches, light sensitivity, and was told by another primary doctor that I had some intestinal infection.Oh and the first ER doctor diagnosed me with Atypical Migraine because he didn't have a clue. This type of Glaucoma is rare and not always easy to diagnosis by symptoms alone.Have you had a thorough eye exam by an ophthalmologist?If you don't think the doctor has it right, see another one.
    Anonymous 42789 Replies Flag this Response
  • Pseudo Tumor Cerebri. How old are you? This is a false tumor that creates an increase of CSF fluid that is not draining. It would worsen with standing, bending, and seem as if related to your hearbeat. I was dx's in 2003. You should see a neurologist, get a lumbar punture done with a beginning and ending pressure. This will determine if PTC is evident. I was then placed on Acetazolamide, sold under the trade name Diamox, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension, altitude sickness, cystinuria, and dural ectasia. Acetazolamide is available as a generic drug and is also used as a diuretic.Do you have a changes in your visual field?Next guess would be a typical migraine.Good luck,Swarty MO
    Anonymous 42789 Replies Flag this Response
  • Pseudotumor Cerebri was my tentative diagnosis before the next diagnosis of Atypical Migraine. I had a needless lumbar puncture and didn't have ANY symptoms of Pseudotumor Cerebri.Months later, my Glaucoma Specialist doctor laughed when she heard the ridiculous tests I had done which were completely unnecessary. johnnyboy said they had a lumbar puncture. Negative.
    Anonymous 42789 Replies Flag this Response
  • Pseudo Tumor Cerebri. How old are you? This is a false tumor that creates an increase of CSF fluid that is not draining. It would worsen with standing, bending, and seem as if related to your hearbeat. I was dx's in 2003. You should see a neurologist, get a lumbar punture done with a beginning and ending pressure. This will determine if PTC is evident. I was then placed on Acetazolamide, sold under the trade name Diamox, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension, altitude sickness, cystinuria, and dural ectasia. Acetazolamide is available as a generic drug and is also used as a diuretic.Do you have a changes in your visual field?Next guess would be a typical migraine.Good luck,Swarty MOI don't have any changes in my visual field - as I said, no other symptoms at all.I'm a 36 year old male, so I don't particularly fit the profile for Pseudo Tumor Cerebri do I?As of last night the pain has decreased quite a bit but there is still intense throbbing if I bend down, or exert myself.I guess Atypical Migraine is the the most likely answer - I just hope it disappears and doesn't come back - having gone through this for a week, I have so much sympathy for people who have lived with this for a much longer time - it's really debilitating :(
    johnnyboy 5 Replies Flag this Response
  • Have a peek at this site http://www.i-h-s.org/ Hope the headache does disappear completely, but the more you worry about what is causing it the more stress you cause yourself and the worse it will become catch 22 as the say.Now to get rid of my 6 year headaches lol
    Anonymous 42789 Replies Flag this Response
  • i have had a headache since dec 31, 2006. i have gone through 2 lps, a wrong diagnosis of ptc (Pseudotumor Cerebri), pain pill after pain pill, treatment after treatment and nothing has worked. somedays are great and others i search online to find out what could be wrong. do normal people have headaches for over a year?
    Anonymous 42789 Replies Flag this Response
  • Hi - I wonder if anyone can help diagnose what might be causing my intense, persistent headache?Almost 5 days ago whilst walking along a corridor I suddenly got struck by the worst headache I've ever had. It came on in a single heartbeat and was immediately agonising. It was an intense throbbing that all but debilitated me and I had to go to bed. I was unable to get comfortable, even with pain killers - the only thing that even slightly alleviated the pain was standing up which slightly reduced the pressure in my head.The pain was evenly distributed around my head and was entirely pulse-based - i.e. it throbbed, and in between heartbeats there was no pain.After putting up with it for around 30 hours, I went to A&E (ER) and was admitted for a CT scan and then a lumbar puncture. I was kept in over night but both tests proved negative for bleeding and I was released with painkillers, and no diagnosis of what might be wrong - other than being reassured that I don't have a SAH or a tumour.I went to my GP the next day and he prescribed more painkillers and told me to take a week off work - suggesting that it might be stress related.Since then (I am now on day 5) the general pain has abated to about half the level it was at the beginning, and seems to now be focussed in the right hemisphere near my ear & eye. However, if I do anything that even slightly raises my blood pressure (such as bending down, or walking up stairs) the throbbing instantly kicks in and then spreads across my whole head. I take Co-Dydromol and Ibuprofen every 4 hours and this mostly keeps the pain at bay, but I wake up in the middle of the night when the pain killers wear off.I have no other symptoms - no neurolical deficit, no fever etc.From what I've read this doesn't seem to fit the profile of a stress-related headache - although I admit I am under a certain amount of stress at the moment. I do not normally suffer from headaches even when stressed, and have never had anything close to this level of pain or duration of pain from a headache before.Does anyone have any ideas what might be going on, or any suggestions for what I should do next?Thanks for any help anyone can give me.Best regards,John.Hi, I notice this is quite an old posting, I have just come out of hospital with the diagnosis of the exact same thing as you, and I was wondering if it has ever returned to you because I am now on day 10 and the headache as subsided quite a bit but not gone away. I have had CT scan MRI scan, lumbar puncture to rule out SHA so thunderclap headache it seems to be. Like you mine came on suddenly I am a 50 year old active lady with no previous headache and mine came on suddenly when skiing. My husband is a doctor and immediately thought SAH so was rushed to hospital. Relived that the tests were all negative I just want to know if it will now go away for ever...I hope so but any effort i do reawkens it and brings on a pounding in my head at the moment.Hope you are feeling betterSally
    Anonymous 42789 Replies
    • January 28, 2011
    • 08:50 AM
    • 0
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  • Hi, I notice this is quite an old posting, I have just come out of hospital with the diagnosis of the exact same thing as you, and I was wondering if it has ever returned to you because I am now on day 10 and the headache as subsided quite a bit but not gone away. I have had CT scan MRI scan, lumbar puncture to rule out SHA so thunderclap headache it seems to be. Like you mine came on suddenly I am a 50 year old active lady with no previous headache and mine came on suddenly when skiing. My husband is a doctor and immediately thought SAH so was rushed to hospital. Relived that the tests were all negative I just want to know if it will now go away for ever...I hope so but any effort i do reawkens it and brings on a pounding in my head at the moment.Hope you are feeling betterSallyHi Sally - sorry to hear you are suffering from what I had - it's pretty scary.The pattern of my headache was exactly the same as you are currently experiencing. It gradually reduced in intensity over the course of about a month, but for about 3 months afterwards I would still get hints of it, especially during exertion or anything that raised the blood pressure in my head - even just bending down. I was also left with a difficult-to-describe "stiff neck" feeling that faded away over time but occasionally returns (when it does it is usually when I wake up in the morning and lasts maybe 30 mins but isn't really painful, just feels a bit odd).In general though, I am glad to say that since this acute attack (which was nearly 4 years ago) I have never experienced anything like it since. Needless to say I hope it stays that way and I hope your situation is the same.Best of luck, and please let us know how you get on,John.
    johnnyboy 5 Replies Flag this Response
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