Ice Pick Headaches: These are characterized by brief, extremely painful, stabbing headaches that can last from a few seconds to up to 30 seconds. They are often described as feeling like a sharp object is being thrust into the skull.

Trigeminal Neuralgia: Although typically longer in duration, some episodes can be brief and are characterized by intense, stabbing pain usually on one side of the face, which can sometimes be perceived as originating in the head.
Cluster Headaches: While these are usually longer-lasting, the pain can be so severe and stabbing that it might be perceived as fitting the 30-second duration if the patient is focusing on the peak intensity.
Hemicrania Continua: A continuous headache with periods of exacerbation that can feel like sharp stabbing pains, though these are typically longer-lasting than 30 seconds.

Subarachnoid Hemorrhage: Although the classic presentation is a "thunderclap headache" that is maximal at onset and lasts longer, some patients might experience a brief, sharp pain as the initial symptom. Missing this diagnosis can be fatal.
Temporal Arteritis: This condition can cause sudden, severe headaches, and while they are typically not brief, the initial presentation could be misleading. Missing this diagnosis can lead to blindness.
Meningitis: The headache in meningitis can be severe and might be described in various ways, including sharp and stabbing. Early diagnosis is crucial to prevent serious complications.

Chiari Malformation: Can cause brief, sharp headaches, especially with coughing or straining, due to the herniation of the cerebellar tonsils into the spinal canal.
Primary Thunderclap Headache: While typically longer-lasting, some variants can present with very brief, extremely severe headaches.
Cervicogenic Headache: Originates from the cervical spine and can cause sharp, stabbing pains referred to the head, though these are usually related to specific neck movements or positions.