When to Seek Emergency Care for a Severe Headache

Understanding Headaches and Their Causes

Headaches are one of the most common medical complaints, affecting people of all ages and backgrounds. The majority of headaches are benign, caused by things like stress, fatigue, dehydration, hormone fluctuations, or dietary triggers. However, some headaches can signal something more serious.

Chelsea occasionally takes aspirin to relieve a headache. When Chelsea gets a headache, it is usually caused by things like:

• Lack of sleep
• Skipping meals
• Staring at screens too long
• Caffeine withdrawal
• Hormone changes during her menstrual cycle
• Stress at work

For these types of headaches, Chelsea finds that OTC pain relievers like aspirin, ibuprofen, or acetaminophen provide quick relief. Staying hydrated, getting adequate rest, reducing stress, and avoiding headache triggers also help prevent recurrent headaches for Chelsea.

Primary vs. Secondary Headaches

Headaches fall into two major categories: primary and secondary. Primary headaches are benign headaches with no underlying cause. These include tension headaches, migraines, and cluster headaches. Chelsea's recurrent headaches are most likely a form of tension headache.

Secondary headaches are symptoms of an underlying medical condition. This includes things like:

• Concussion
• Blood clots
• Brain tumor
• Carbon monoxide poisoning
• Dehydration
• Infection like meningitis
• High blood pressure

Secondary headaches signify something more serious is happening in the body and require medical investigation and treatment.

Headache Red Flags

Most headaches are perfectly normal and not a cause for concern. However, some headache patterns and symptoms may be red flags signaling something more sinister. Red flags include:

• Sudden onset of severe headache
• Headaches increasing in frequency or severity
• New headache after age 50
• Headache waking you from sleep
• Headache triggered by coughing, bending over, or exertion
• Headache accompanied by fever, neck stiffness, nausea/vomiting, vision issues, loss of coordination, or speech problems
• Headaches that worsen with rest
• Headaches only on one side of the head
• Very painful headaches (i.e. worst headache of your life)
• Headaches following head injury
• Headaches during pregnancy or postpartum period

When to See a Doctor About Headaches

Most people experience headaches occasionally and dont need to see a doctor every time. However, if you experience any red flag symptoms, its important to make an appointment with your physician for evaluation. This is especially true if the headache is sudden and severe or if it is a dramatic change from your normal headache pattern.

Seeking Emergency Care

In some cases, you may need to seek emergency medical care for a severe headache. Go to the emergency room or call 911 if you experience:

• Sudden, severe headache accompanied by confusion or trouble speaking
• Headache following a blow to the head or other head injury
• Sudden headache along with fever and neck stiffness
• Severe headache along with vision changes, double vision, dilated pupils, eye pain, or light sensitivity
• Headache along with weakness or numbness on one side of the body
• Very painful headache in pregnant women or postpartum women

Symptoms like these can signify a medical emergency like hemorrhage, meningitis, or stroke. Waiting to see if symptoms resolve on their own can have catastrophic consequences, so emergency evaluation is warranted.

Making a Doctor's Appointment

Schedule an appointment with your primary care physician promptly if you have:

• Recurring headaches increasing in frequency or severity
• A very painful, severe headache different from previous headaches
• New onset of headache after age 50
• Headaches that wake you from sleep
• Headaches with exertion, coughing, or certain positions
• Persistent headache following head injury
• Headaches along with vision, speech, or coordination problems
• Headaches and accompanying fever, nausea, or vomiting
• Weakness or numbness on one side of the body
• Unexplained weight loss along with headaches

Don't try to self-diagnose headaches that have unusual features or fall outside your normal headache patterns. See a doctor promptly for evaluation. Sometimes imaging tests like CT scans or MRIs are needed to diagnose the cause of headaches.

Causes of Headaches Requiring Medical Care

Headaches can arise from many underlying conditions. Some require prompt medical care for diagnosis and treatment. Common causes include:

Blood Clots

A headache accompanied by neck pain or tenderness can be a sign of cerebral venous sinus thrombosis (CVST), a blood clot in the veins draining blood from the brain. CVST is rare but requires emergency treatment to prevent complications. Other symptoms may include:

• Stroke-like symptoms
• Blurry vision
• Fainting
• Seizures

Brain Bleed

A sudden, severe headache, sometimes called thunderclap headache, can signal bleeding in the brain. This is an emergency requiring immediate medical attention to relieve pressure on the brain and prevent long-term damage or death. Causes include:

• Ruptured aneurysm - balloon-like bulge in artery wall bursts
• Head trauma
• Stroke
• Arteriovenous malformation (AVM) - tangles of abnormal arteries and veins

Brain Tumor

Headaches caused by brain tumors tend to be worse in the morning and ease during the day. They may occur along with:

• Nausea and vomiting
• Vision or speech problems
• Loss of coordination
• Seizures
• Changes in senses, memory, or cognition
• Changes in personality

Treatment depends on the tumor type, size, and location but may include surgery, radiation, and chemotherapy.

Encephalitis / Meningitis

Inflammation or infection of the brain (encephalitis) or surrounding membranes (meningitis) can cause severe headache along with:

• Fever
• Confusion
• Seizures
• Photophobia
• Neck stiffness

These require prompt diagnosis via spinal tap and treatment with IV antibiotics or antivirals to prevent complications. Viral infections are more common causes than bacterial ones.

Giant Cell Arteritis

This condition causes inflammation of blood vessels in the head, especially in older adults. Symptoms include:

• New headache after age 50
• Scalp tenderness
• Jaw pain with chewing
• Vision changes
• Fever, fatigue, weight loss

If left untreated, it can lead to irreversible blindness. Fast treatment

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.