Headaches - danger signs
A headache is a pain or discomfort in the head, scalp, or neck.
Common types of headaches include tension headaches, migraine or cluster headaches, sinus headaches, and headaches that begin in your neck. You may have a mild headache with a cold, the flu, or other viral illnesses when you also have a low fever.
Most people with headaches feel better by making lifestyle changes, such as learning ways to relax. Taking certain medicines, such as pain medicine, may also help.
Migraine headache - danger signs; Tension headache - danger signs; Cluster headache - danger signs; Vascular headache - danger signs
Emergency Causes of Headaches
Problems with blood vessels and bleeding in the brain can cause a headache. These problems include:
- Abnormal connection between the arteries and veins in the brain that usually forms before birth. This problem is called an arteriovenous malformation, or AVM.
- Blood flow to part of the brain stops. This is called a stroke.
- Weakening of the wall of a blood vessel that can break open and bleed into the brain. This is known as a brain aneurysm.
- Bleeding in the area between the brain and the thin tissue that covers the brain. This is called a subarachnoid hemorrhage.
Other causes of headaches that should be checked by a health care provider right away include:
- Blood pressure that is very high
- Brain tumor
- Buildup of fluid inside the skull that leads to brain swelling (hydrocephalus)
- Buildup of pressure inside the skull that appears to be, but is not, a tumor (pseudotumor cerebri)
- Carbon monoxide poisoning
- Infection in the brain or the tissue that surrounds the brain, as well as a brain abscess
- Swollen, inflamed artery that supplies blood to part of the head, temple, and neck area (temporal arteritis)
When to Call the Doctor
If you cannot see your provider right away, go to the emergency room or call 911 if:
- This is the first severe headache you have ever had in your life and it interferes with your daily activities.
- You develop a headache right after activities such as weightlifting, aerobics, jogging, or sex.
- Your headache comes on suddenly and is explosive or violent.
- Your headache is "the worst ever," even if you regularly get headaches.
- You also have slurred speech, a change in vision, problems moving your arms or legs, loss of balance, confusion, or memory loss with your headache.
- Your headache gets worse over 24 hours.
- You also have fever, stiff neck, nausea, and vomiting with your headache.
- Your headache occurs with a head injury.
- Your headache is severe and just in 1 eye, with redness in that eye.
- You just started getting headaches, especially if your are older than 50.
- You have headaches along with vision problems and pain while chewing, or weight loss.
- You have a history of cancer and develop a new headache.
- Your immune system is weakened by disease (such as HIV infection) or by medicines (such as chemotherapy drugs and steroids).
See your provider soon if:
- Your headaches wake you up from sleep.
- A headache lasts more than a few days.
- Headaches are worse in the morning.
- You have a history of headaches but they have changed in pattern or intensity .
- You have headaches often and there is no known cause.
Digre KB. Headaches and other head pain. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2015:chap 398.
Garza I, Schwedt TJ, Robertson CE, Smith JH. Headache and other craniofacial pain. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 103.
Kwiatkowski T, Friedman BW. Headache disorders. In: Marx JA, Hockberger RS, Walls RM, et al, eds. Rosen's Emergency Medicine: Concepts and Clinical Practice. 8th ed. Philadelphia, PA: Elsevier Mosby; 2013:chap 103.
Reviewed By: Joseph V. Campellone, MD, Division of Neurology, Cooper University Hospital, Camden, NJ. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.