When a headache may mean something serious
As a rule, a headache is nothing to be too concerned about. It's the most common form of pain, according to the National Institute of Neurological Disorders and Stroke (NINDS). Very few headaches have serious underlying causes.
However, certain types of pain, or headaches that come along with other key symptoms, call for immediate medical attention.
According to the NINDS, headaches can sometimes be symptoms of:
- Cerebral aneurysms. An aneurysm forms when part of a vein or artery in the brain starts to balloon or bulge. A growing aneurysm may cause problems with vision or a loss of feeling in the face. An aneurysm may also burst. Just before it ruptures, it may cause a sudden and severe headache, nausea, vomiting, loss of consciousness and trouble seeing.
- Strokes. A stroke happens when a blood vessel in the brain bursts open or becomes fully clogged, cutting off blood supply. A stroke usually causes a sudden, severe headache, and can also cause confusion, trouble speaking or moving, or vision problems.
- Subdural hematomas. This buildup of blood in the brain may happen because of blood vessels damaged by head trauma. The pooling blood can press into brain tissue, causing headaches, weakness, confusion, memory loss and seizures.
- Giant cell arteritis (formerly called temporal arteritis). This condition causes irritation or swelling of arteries in the head. It causes a throbbing headache with fever, loss of appetite and sometimes blurred or lost vision.
- Meningitis or encephalitis. These infections can cause swelling of the brain or the tissue around it. They usually bring a headache, fever and stiff neck.
- Brain tumors. Tumors can cause headaches by pushing on the nerve tissue that covers the brain or against blood vessel walls. Headaches caused by tumors often feel like a strong pressure on the head, and may be constant or come and go.
According to the NINDS, any of the following symptoms are reason to see a doctor:
- A sudden, severe headache that may be accompanied by a stiff neck.
- A severe headache accompanied by fever, nausea or vomiting that isn't related to another illness.
- "First" or "worst" headache, often accompanied by confusion, weakness, double vision or loss of consciousness.
- A headache that worsens over days or weeks or has changed in pattern or behavior.
- A recurring headache in children.
- A headache that occurs after a head injury.
- Headache and a loss of sensation or weakness in any part of the body (this could be a sign of a stroke).
- Headache associated with convulsions.
- Headache associated with shortness of breath.
- Two or more headaches a week.
- A persistent headache in someone who has been previously headache-free, particularly in someone over age 50.
- New headaches in someone who has a history of cancer or HIV/AIDS.