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Forum Name: Headaches

Question: Thunderclap Headache


 Trasee - Sun Aug 02, 2009 1:35 pm

Can you tell me if my symptoms are a "Thunderclap Headache" and if I should be alarmed by these symptoms?

I awoke to sharp stabbing pains in one specific spot on the side of my head.
Location is about 1 1/2 inches above my right ear and about 2 1/2 inches behind my ear. The area of pain is about the size of a quarter (coin). This pain only lasts a second and may repeat every 3 to 5 seconds or stop for up to an hour before it happens again. Also, my right shoulder and arm jerk when the pain strikes. I have a low grade fever of 99.8 and I am extremely drowsy. (Took a 5 hour nap yesterday.) I feel nothing with pressing on this area with my fingers and it does not cause pain to press. This pain comes and goes weather I move my head or stay still.

Today, I'm still experiencing these random stabbing pains but also have an "icey hot" sensation inside of my skull around the area of my pain. This "icey hot" sensation is about the size of a baseball.
I feel pretty good in between these pains other than extreme fatigue.
 John Kenyon, CNA - Tue Nov 24, 2009 9:05 pm

User avatar Hello -- Thunderclap or "exploding head" headaches generally are more nearly global or at least hemispheric and not so highly localized as you describe. Also while sudden in onset they generally last longer than what you're having. What you describe sounds, based on the pain alone, like a problem with a segment of one of the cranial nerves. The "icey hot" sensation also sounds like possibly a nerve issue, although this is fairly unusual with cranial neuralgias, so it raises the question of whether or not there is something inside your head pressing on this never. Since there are few moving parts inside the skull this seems fairly unlikely, and tumors and aneurysms don't generally pulsate or lash out randomly. This pulls us further away from a mass and nearer the possibility of a neuralgia, most likely, based on the location, probably involving a branch of the VII or trigeminal nerve (which innervates the face, so most often is known for causing stabbing pains in the face or eye on one side). This particular presentation you describe is fairly common (although the "icey hot" sensation is fairly unusual to my knowlege). This shouldn't be a cause for concern so long as it does not progress and there are no addtional symptoms. If this is a cranial nerve branch it should respond well to over-the-counter anti-inflammatories such as naproxyn (Aleve). There is also the possibility this may be the herald symptom of shingles, and if that's the case there will shortly appear some blisters or scabbing right on or very near the site of the pain. These little vesicles generally follow the path of an affected nerve.

I of course could be wrong about this and there could be something else going on. The best course, if there is ever doubt, is always to consult a medical doctor directly. We are only equipped, in most cases, to speculate here on line. Given the description I would strongly suspect a transient neuralgia which should respond to non-steroidal anti-inflammatories. If any additional symptoms should appear, however, as always, you should immediately be evaluated for possible obscure intracranial problems. It seems extremely unlikely, but I would be remiss if I didn't add that caveat. I really think you have a cranial nerve irritation that will likely pass shortly, although it may very likely recur at some other time, and could herald shingles or even be the result of a limited case of shingles from the past which was missed due to the location on the scalp.

I hope this is helpful to you. Good luck with this, and please follow up with us here as needed.

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