Thunderclap headache associated with a nonhemorrhagic anaplastic oligodendroglioma

A thunderclap headache is a severe headache with sudden onset similar to a clap of thunder, with a maximum intensity within 1 minute. The primary types (thunderclap, cough, exertional, and sexual) can recur intermittently and are generally associated with a benign outcome. The diagnosis results from exclusion of a long list of secondary causes with the most common being subarachnoid hemorrhage. Other secondary causes include unruptured intracranial aneurysm, cerebral venous thrombosis, cervical artery dissection, spontaneous intracranial hypotension, pituitary apoplexy, retroclival hematoma, ischemic stroke, acute hypertensive crisis, hypertensive reversible posterior leukoencephalopathy, third ventricle colloid cyst, intracranial infection, and complicated paranasal sinusitis.