Abstract

Thunderclap headache (TCH) manifests as an acute and severe headache which is maximum in intensity at onset reminding one of a “clap of thunder”. TCH has been reported that can be caused by various etiologies, but ischemic stroke has been reported seldom as a cause of TCH. We report a case of 69-year-old woman presented with TCH as the primary clinical feature of posterior circulation (right posterior cerebral artery and small left superior cerebellar artery territories) cerebral infarct. TCH may be managed as a medical emergency because, in some cases, it can cause serious sequelae. We propose that adequate brain imaging studies should be performed to detect the serious underlying etiologies of TCH such as ischemic stroke and unruptured intracranial aneurysm.