The Worst Headache of My Life: Aneurysmal Subarachnoid Hemorrhage

Thunderclap headache (TCH), so named because it strikes suddenly, like a clap of thunder, is associated with life-threatening aneurysmal subarachnoid hemorrhage (aSAH). Hemorrhagic stroke should always be suspected with signs and symptoms of TCH. The author experienced a TCH, aSAH, craniotomy, and neurointensive care. The goals of this article are to increase primary care provider TCH awareness, empower nurse practitioners to suspect and assess for aSAH, and aid the aSAH victim in navigating the experience. Patients who are misdiagnosed at the first point of medical contact and bleed again have a worse prognosis.