When do you know a headache is serious?

We all have headaches from time to time. Usually headaches are not due to serious health problems. Instead, they could be due to dehydration, lack of sleep, stress, migraines, or allergic coughs and colds.

Headaches can be painful and keep us from doing our job. But we don’t take them seriously. Instead of consulting the doctor, sometimes we prefer over the counter medicines and get instant relief.

It can have adverse effects in the long run.

Let’s understand when the headache becomes life-threatening and needs urgent medical attention.

Headache that may require immediate medical attention

Headaches are pain in your head, neck, and face. If you have other symptoms besides a headache, see your doctor immediately. Your headache becomes a worrying problem if you experience the following symptoms:

  • Thunderclap headache: Sudden intense headache that peaks within 60 seconds and lasts up to 5 minutes.
  • Headache accompanied by symptoms such as blurred vision or light around objects (auras).
  • Headache with speech problems
  • Headaches get worse over time
  • Sudden and severe headache
  • Fever and stiffness in the neck, nausea and vomiting
  • Headache associated with nosebleed
  • Pain that gets worse when you change position or that can even wake you from a deep sleep
  • Dizziness and fainting
  • Headache associated with weakness or numbness on one side of the face or one side of the body
  • Difficulty walking or loss of balance while walking
  • If you feel confused and have trouble understanding what people are talking about
  • Hearing problems
  • If you feel a headache after any exertion or after sneezing and coughing
  • A sensitive area on your head
  • Headache associated with night sweats or unexplained weight loss

What Medical Conditions Can Cause Headaches?

Headaches can occur due to dehydration, flu, muscle tension, drug side effects, drug withdrawal, toothache, alcohol hangover, or hormonal changes.

But headaches can be a symptom of a number of serious illnesses or conditions, such as:

  • high bloodpressure
  • tension
  • sinusitis
  • Sunstroke
  • Migraine
  • Meningitis
  • Cerebral stroke
  • brain abscess
  • Concussion or any head injury
  • preeclampsia
  • brain cancer
  • bulge of the wall of a cerebral artery
  • stroke
  • Infections such as Lyme disease

Treatment of headache

Headaches are one of the most common pain-causing conditions worldwide. See your doctor immediately if you or your child have frequent headaches. Treatment for headaches depends on the cause of the headache. Your doctor will take your medical history and do a comprehensive physical exam in case of injury. To find the right cause of headaches, your doctor may suggest some diagnostic tests, such as:

  • Vision and eye test
  • ear examination
  • examine blood
  • Test of the spinal fluid
  • CT-scan
  • MRI scanning
  • Electroencephalography (EEG)

After diagnosis, your doctor will prescribe an appropriate treatment regimen, such as:

  • Rest and applying heat or cold compresses to the head can help with headaches.
  • Counseling and stress management: Stress can also be a triggering factor for your headaches. A psychiatrist’s counseling and stress management techniques can help you.
  • If your headaches are due to high blood pressure, the right medication, regular blood pressure monitoring, and dietary adjustments can improve symptoms.
  • Preeclampsia is a life-threatening condition. Headaches in the third trimester of pregnancy can be a symptom of preeclampsia in pregnancy. It is a major cause of morbidity and mortality in pregnant women and neonates. So, if you suffer from severe headache during pregnancy, get immediate treatment.
  • In case of migraine, your doctor will suggest a combination therapy.
  • One needs immediate medical attention for headaches due to emergency situations such as stroke, brain aneurysm or cerebral hemorrhage. The treatment of these conditions is complex. The prognosis becomes very good with proper diagnosis and prompt treatment.
  • Headaches can also be a symptom of brain infections caused by viruses, bacteria, fungi, or parasites. Treatment for a brain infection depends on the cause. This includes antibiotics, antiviral medications, and corticosteroids.

Headaches are usually not a cause for concern. However, sometimes headaches can be a symptom of a life-threatening illness or condition. Whatever the reason, seek medical advice if you experience frequent headaches.

Dr Amit Shrivastava, Senior Consultant – Neurology, Dharamshila Narayana Superspeciality Hospital, New Delhi

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