Abstract

Thunderclap headache(TCH) begins suddenly and is severe at onset. There are many kinds of cause including headache attributed to hypertensive crisis. Headache is generally regarded as a symptom of high blood pressure despite the conflicting opinions on the association of headache and arterial hypertension. Acute hypertensive crisis can be easily overlooked in a patient presenting with TCH. In such cases, hypertension might be misconstrued as a part of stress response, secondary to TCH. Two young adult women complained recurrent TCH. When they suffered from headache, the systolic blood pressure was above 160mmHg. There weren't response to analgesics but antiypertensive medication. These head- aches are fulfilling the ICHD-II criteria for headache attributed hypertensive crisis without hypertensive encephalopathy. We suggest hypertensive crisis might be required in the differential diagnosis of TCH.