It all started when the unidentified 34-year-old male entered a hot-pepper-eating contest, during which he consumed one Carolina Reaper pepper. The little red fruit was bred specifically for its spiciness, and it currently holds the Guinness World Record for the highest number of Scoville Heat Units, a measurement of chemical compounds called capsaicinoids.
The man immediately began dry heaving, which isn’t terribly surprising. But he also experienced several seconds of intense head and neck pain. The sudden pain was so bad—and returned several times over the next few days—that he wound up in the emergency room.
In the ER, a computed tomography (CT) scan showed that several arteries in the man’s brain were narrower than they should be, prompting his doctors to diagnose him with “thunderclap headaches” caused by a condition called reversible cerebral vasoconstriction syndrome (RCVS).
Luckily, the patient’s headaches went away on their own, and a second scan five weeks later showed that his arteries had returned to normal. But his experience raises several questions—like, what is a thunderclap headache, and is it dangerous? And is it normal to get them from spicy foods?
According to Troy Madsen, MD, an emergency medicine researcher at the University of Utah, thunderclap headaches come on very suddenly and usually last less than five minutes. “They hit you just like a crack of lightning and that sound of thunder,” says Dr. Madsen, who was not involved with the hot-pepper case. “It’s all of a sudden, out of nowhere, 10-out-of-10 pain that reaches its maximum intensity within seconds.”
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