Signs That Let You Know When to Worry About a Headache

A headache typically causes pain in your head, face, or neck area. Get urgent medical attention if you have severe, unusual pain or other signs and symptoms. Your headache may be a sign of an underlying illness or health condition.

Your headache pain may be serious if you have:

• sudden, very intense headache pain (thunderclap headache)
• severe or sharp headache pain for the first time
• a stiff neck and fever
• a fever higher than 102 to 104°F
• nausea and vomiting
• a nosebleed
• fainting
• dizziness or loss of balance
• pressure in the back of your head
• pain that wakes you from sleep
• pain that gets worse when you change position
• double or blurred vision or auras (light around objects)
• face tingling and auras that last longer than an hour
• confusion or difficulty understanding speech
• droopiness on one side of your face
• weakness on one side of your body
• slurred or garbled speech
• difficulty walking
• hearing problems
• muscle or joint pain
• pain that begins after coughing, sneezing, or any type of exertion
• constant pain in the same area of your head
• seizures
• night sweats
• unexplained weight loss
• tenderness or a painful area on your head
• swelling on your face or head
• a bump or injury on your head
• an animal bite anywhere on your body

Normal headaches are usually caused by dehydration, muscle tension, nerve pain, fever, caffeine withdrawal, drinking alcohol, or eating certain foods. They may also happen as a result of toothache, hormonal changes, or pregnancy or as a side effect of medication.

Migraine pain can come on without warning and can be severe and debilitating. If you have chronic migraine, talk to your doctor about treatment to help you manage this pain.

Headaches can be a symptom of some serious illnesses or health problems, including:

• severe dehydration
• tooth or gum infection
• high blood pressure
• heatstroke
• stroke
• head injury or concussion
• meningococcal disease (brain, spinal cord, or blood infection)
• preeclampsia
• cancer
• brain tumor
• brain aneurysm
• brain hemorrhage
• Capnocytophaga infection (commonly from a cat or dog bite)

Call 911 if you think you or someone else may be having headache pain because of a medical emergency. Serious, life-threatening illnesses that cause headaches and need urgent attention include:

Stroke

In the United States, someone has a stroke every 40 seconds. About 87% of strokes happen because blood flow to the brain is blocked.

A stroke is preventable and treatable. Prompt medical attention is important for successful treatment. Call 911 if you have stroke symptoms. Do not drive.

what to do if you suspect a stroke

Act F.A.S.T. if you or someone else may be having a stroke:

• Face: Does one side of their face droop when you ask them to smile?
• Arms: Can they raise both arms over their head?
• Speech: Do they slur their speech or sound strange when they talk?
• Time: If you see any signs of stroke, call 911 immediately. Treatment within 3 hours of having a stroke increases the chances of a better recovery.

Concussion

If you have a head injury, you may have a concussion or a mild brain injury. Get immediate medical help if you have symptoms of a concussion after a fall or a blow to the head. These include:

• headache
• dizziness
• nausea or vomiting
• blurred vision or double vision
• drowsiness
• feeling sluggish
• balance problems
• slowed reaction time

Heatstroke

If you overheat in warm weather or during excess exercise, you may have heatstroke. If you suspect heatstroke, move into the shade or an air-conditioned space. Cool down by drinking cool water, putting on wet clothes, or getting into cool water.

Look for these warning signs of heatstroke:

• headache
• dizziness
• nausea
• vomiting
• muscle cramps
• dry skin (no sweating)
• pale or red skin
• difficulty walking
• fast breathing
• fast heart rate
• fainting or seizures

Preeclampsia

Headaches in the third trimester of pregnancy can be a symptom of preeclampsia. This health complication causes high blood pressure. It can lead to liver and kidney damage, brain injury, and other serious problems. Preeclampsia usually begins after week 20 of pregnancy.

This blood pressure condition happens to up to 8 percent of pregnant women who may be otherwise healthy. It is a leading cause of death and illness in mothers and newborn babies.

symptoms of preeclampsia

Get urgent medical treatment if you are pregnant and have symptoms such as:

• headache
• stomach pain
• difficulty breathing
• nausea and vomiting
• burning pain in your chest
• blurred vision or flashing spots in vision
• confusion or anxiety

Treatment for serious headache pain depends on the underlying cause. You may need to see a neurologist (brain and nervous system specialist). Your doctor may recommend several tests and scans to help diagnose the cause, such as:

• medical history and physical exam
• eye exam
• ear exam
• blood test
• spinal fluid test
• CT scan
• MRI scan
• EEG (brain wave test)

You may need intravenous fluids (through a needle) to treat conditions like severe dehydration and heatstroke.

Your doctor may prescribe daily medications to treat a health condition like high blood pressure. A serious infection may be treated with antibiotics or antiviral medication.

If you have serious headache pain due to a chronic condition like migraine, your doctor might recommend prescription drugs to help prevent or reduce migraine pain.

If you have high blood pressure, take medication as prescribed to help lower it. Follow a low-sodium diet to keep your blood pressure from spiking. Check your blood pressure regularly on a home monitor. This can help prevent serious headaches caused by high blood pressure.

You don't have to worry about most headache pain. Headaches have many causes, and most of them are not serious. In some cases, headache pain can be a symptom of a serious health condition or illness.

Get immediate medical attention if your headache pain is different or more severe than you have felt before. Tell your doctor about any other symptoms you have along with headache pain.

If you are pregnant, let your doctor know about any headache pain and whether you have a history of high blood pressure. It is also especially important to see a doctor about any severe or chronic headache pain if you have an underlying health condition.