Blood vessel disorders can cause headache because the blood vessels stretch, leak blood into the brain, or create pressure on brain cells. Aneurysm headache and headache caused by associated disorders often have a thunderclap onset. Some of the main disorders associated with headache are:
- Vascular malformations (such as aneurysm)
- Haemorrhage (a type of stroke)
- Tearing of an artery in the neck
Unruptured Vascular Malformation (i.e. aneurysm)
Unruptured vascular malformations (such as aneurysms, or other arterial disorders) can cause headache due to the stretching of blood vessels, abnormal blood flow, or increased pressure associated with these diseases. They require diagnosis by neuroimaging (e.g., CT or CAT brain scan, or MRI brain scan). Generally, if the pain is localised to one area of the head and has a sudden onset, it could be a sign of a vascular disorder. In the case of unruptured aneurysms, the headache has a thunderclap onset, or could be associated with a painful third nerve palsy (causing a person’s eye to look down and outward, and the eyelid to droop).
Haemorrhage / Ruptured Aneurysm
Headache attributed to intracranial haemorrhage is usually localised to the site of the haemorrhage, and has a sudden or thunderclap-type onset. The pain is most severe on the first day. Onset is typically accompanied by other focal neurological symptoms. In some cases, such as for subarachnoid haemorrhage, headache may be the only symptom. Headache can also become persistent, and continue to affect the person after the haemorrhage has stabilised.
Tearing of Artery in the Neck
Tearing (or ‘dissection’) of an artery in the neck (carotid or vertebral artery) can cause headache, facial pain, and neck pain on the same side of the head as the dissection. The pain is normally severe, having a sudden thunderclap onset, and may last for days. This pain could be isolated, or it could be followed by signs of stroke, so it’s important to see a doctor to prevent any further complications from developing.
Haemorrhage and aneurysm headache, alongside other blood vessel disorders, are symptoms of serious medical issues that should be investigated by a doctor. Here are some more detailed articles describing these disorders:
Subarachnoid Haemorrhage – Brain Foundation
Aneurysm – Brain Foundation
Arteriovenous Malformation – Brain Foundation
Other disorders include arteritis, cranial venous disorders (such as thrombosis), and genetic vascular disorders.
Stroke-related Headache – description of headaches attributed to stroke