“Thunderclap” Migraines

Sounds similar to my experience with trigeminal neuralgia.

Hi, @fightingfibro0505 - This topic on thunderclap migraines/headaches merits discussion and input from Connect members.

Tagging some members who have mentioned this type of headache for their input on dealing with the electric shock feeling in your head, fightingfibro0505: @briarrose @jola13 @lilyabbyjr14 @pamclark. @clappies1990 @fromthehill @jenniferhunter also may have thoughts for you on managing these painful headaches.

While waiting for these members to respond, I thought this Mayo Clinic information might be useful:

- Thunderclap headaches
https://www.mayoclinic.org/diseases-conditions/thunderclap-headaches/symptoms-causes/syc-20378361
How is this going for you, fightingfibro0505? Are you still experiencing the electric shock type sensations you mentioned?

Yes, this health emergency deserves further discussion. Especially since so many folks have no idea what you are talking about when you say "I had to go to the ER, I had a thunderclap headache." Most folks will say "thunderclap h/a? what's that?" As noted on the Mayo Clinic site there are many causes. My particular situation was as follows - I went to the gym to meet my personal trainer as usual. That AM I was really tired and NOT drinking enough water. Ending up my session, I did one very strenuous exercise...then stupidly I decided to do the punching bag.
Mind you, I had fatigue plus I was dehydrated. My PT (who I longer see) never advised me NOT to continue or to get my water bottle - which, again, I stupidly left in my locker, huge mistake, not sure why I did that.
I love the punching bag, great stress reliever so I went pretty heavy on it. Suddenly, without warning, BAM!!!
My head felt like it was going to explode! I started screaming...my PT didn't look to upset and stood there. I yelled at him to call 911. He actually thought it was nothing serious. EMTs came and took my blood pressure, I didn't want to know the numbers but they said it was sky high - a hypertensive crisis. My PT said "does she really need to go to the hospital?". The female EMT said, quite firmly "yes, she certainly does". I had to go out the back door so the other people working out didn't see me. In the ER I got IV medications...one I had a reaction to. I felt I was losing consciousness. Slowly my B/P came down but it took awhile. Moral of my story?
When working out, drink plenty of water. If feeling tired, don't push yourself, PACE yourself. Clearly my thunderclap h/a could have been avoided. But I was simply not thinking straight that day. I know better.
Also, did you know that orgasms can also bring on a thunderclap? I didn't know this until I read up on more causes. So I have to be careful with my husband...I won't chance it. It was a horrific experience. I was 65 at the time and I figured I had enough orgasms during my life. So that part of my life ended. But no biggie, I had to accept it. I am now 70 and never had another one. Stay hydrated, watch your blood pressure and don't push yourself during exercise...the other causes of a thunderclap are so very serious. However, fightingfibro0505, I would not describe the pain of a thunderclap as "electric shock" like. The pain is like an explosive going off in your brain. I also have migraines and have had "brain spasms" which are actually migraines called "Periodic Brain Spasms". They last only seconds but extremely uncomfortable. It they lasted any longer, it would be a 911 call - they are that bad. Perhaps this is what you are actually experiencing? Hope you have a good neurologist.
Best of luck to you.

@fightingfibro0505 Cervical spine issues can generate some bad headaches. Typically, muscle spasms move the vertebrate around and cause some tension in the muscles. In my case, with one side of my neck tighter because of thoracic outlet syndrome, I get one sided headaches when this happens. Getting my neck properly aligned again with my physical therapist relieves the tension and the headaches. My PT also does myofascial release which is all about releasing excess tensions.

Here is our discussion where you may learn more.
Neuropathy - "Myofascial Release Therapy (MFR) for treating compression and pain"
https://connect.mayoclinic.org/discussion/myofascial-release-therapy-mfr-for-treating-compression-and-pain/
There is a provider search at https://mfrtherapists.com/

@briarrose
I'm 55 and going through the EXACT same thing right now. For the last 4 days every time I have a bowel movement or orgasm. TERRIBLE shooting headache my brain is throbbing and high blood pressure. I had a CT Scan with and without dye. there is no annuerysm, tumor or bleed.... so WHY is this happening? It's freaking me out, doctors don't seem too worried now that the CT Scan didn't show much. So am i supposed to just live like this??? One of my doctors said it may be hormonal? I am perimenopausal, so its possible. You are the only one I've seen online that has had similar symptoms. Did it ever happen again? Today is day 5.... Its happened 4 days in a row (and once during orgrasm) I haven't had sex with my husband since. This is scaring me. All doctors gave me was Ibuprofen, blood pressure meds (i've never had BP issues before) and Trazadone to help me sleep... I have a mild headache all day since the first one happened 4 days ago and I have to take my blood pressure 3x a day. Its normal until i have a BM or orgasm... I can't find much online about it either... any more insight you can provide is much appreciated!!!

Well denimart, sorry to say, I don't really have good news for you.
Everything points to "Primary Exertional Headaches" and/or "Thunderclap Headache" which I previously described to you. PEH occurs exactly as stated with "exertion". Such as tensing or straining the abdominal muscles (being constipated and trying to poop), heavy lifting, coughing, sneezing and, as you unfortunately found out, an orgasm. Usually lasting seconds to minutes but with repeated exertion may build and become longer in duration. When first evaluating a patient, a CT scan or brain MRI is done. You had the CT scan already, showing nothing...personally I think a brain MRI would have been better. If all looks well in your brain, then it is called "primary" as oppose to "secondary" which would be for example...a person experiencing a massive headache in response to a stroke. I believe, and I am no neurologist!, you are describing a "thunderclap headache" especially since you said you develop high blood pressure along with terrible head pain.
How high is high? There is such a condition as "hypertensive crisis" which warrants a visit to the ER. This is a severe, sudden blood pressure in the range of 180/120 or more brought on by many possible causes which have to be ruled out. But with your CT scan, conditions such as: a bleed in the brain, rupture of a blood vessel in the brain, or a tear in the lining of an artery, blood clot in the brain, stroke, brain infections, etc. - have all been ruled out. Which leaves standing - a sudden, severe jump in your blood pressure. And you have discovered a hard strain of your abdominal muscles - as in trying to expel constipated hard stools causes that severe, sudden increase in B/P and what follows is that terrible, exploding, frightening headache. A "Thunderclap".
And as well - the "pushing" to have an orgasm will increase your B/P so severely that it causes a terrible, massive thunderclap headache. Do you have a history of migraines (there are several types)? Did you ever suffer trauma to your head as in a fall, car accident, etc.? Did you every suffer a concussion? Symptoms of which can show up months after the initial head trauma. It took 11 months for my symptoms (a thunderclap headache) to develop after my concussion. And as I reported, I was dehydrated (never good) and exercising like a mad woman PLUS I had a history of head trauma in a fall PLUS I suffer from migraines - as a result of that concussion. Whew!
You say you have mild headaches for days post severe headache (thunderclap headache). Believe it or not, I had a migraine for 9 months after my thunderclap headache...tried a multitude of medications, nothing helped but time. In a thunderclap headache the blood vessels in the brain suddenly, severely EXPAND, your B/P goes sky high and BOOM! My brain MRI (at the time 6 years ago) was normal. Now at age 70 it is not. My personal opinion is that I kick started this condition after my head trauma and because of that - when I was dehydrated (the brain is mostly water), fatigued and hitting a punching bag like Muhammad Ali - I had my Thunderclap!!
What to do? Get a "Headache Specialist" - all such specialists are neurologists but not ALL neurologists are headache specialists. Watch the level and intensity of any exercise you do. Slow and steady wins the race. Keep full hydrated at all times. Take a stool softener or increase fiber (docusate/Metamucil) to AVOID those hard stools...they are your enemy. Watch your level of fatigue. Continue to monitor your blood pressure recordings. Naturally avoid stress as much as possible, ever think of trying meditation? Yoga? Now what can I say about sex?
I had to bite the bullet and simply give up (not sex) but the effort to push through an orgasm. I continue to have our "version" of sex but without the orgasm for me. Fair? Heck, no! But I never want to experience that thunderclap headache ever ever again. And I haven't. And the way I figure it - after my divorce in my 50s I got involved with a sex obsessed man (who was into kinky) and I had sex constantly! It was fun while it lasted...so I feel I had my fill of wild and crazy sex. Now with my beloved, wonderful 2nd husband - we go nice and easy and improvise. And it works! And your question as to the WHY does this happen to me...review my questions, see if you are there for a possible, probable causes. If not, I was told once by a neurologist that so much is still unknown about the brain. I have simply accepted this is my life now. I believe I know my "why"...I would (again) strongly suggest a new headache specialist/neurologist for you. And see if you can get a brain MRI...it is the gold standard in testing the brain. All the best to you! Keep me updated and be well! 🙂