Headaches can frequently be managed with home remedies and generally aren’t a reason for alarm; however, certain headaches necessitate immediate medical care. For example, a quick-onset, intense headache could indicate a stroke.
In the context of emergency department visits, about 0.5–4.5%Trusted Source of cases involve non-traumatic headaches as per research published in PLOS ONE.
This discussion explores various triggers and indicators of severe headaches. It also provides guidance on when to seek professional medical assistance.
‘Red flag’ symptoms
Headaches require immediate medical attention when they present with certain symptoms:
A swift and intense headache that peaks within minutes.
A headache that worsens or changes when a person moves.
A headache triggered by coughing, sneezing, or exerting pressure.
A persistent headache that doesn’t subside.
A headache starting after the age of 50.
A headache coupled with systemic symptoms like fever, chills, night sweats, or unexplained weight loss.
A headache beginning in someone without a prior history of headaches or migraines.
A notable change in headache patterns or frequency.
A headache that is consistently localized in the same area.
Neurological symptoms, such as visual changes, one-sided numbness or weakness, or altered speech.
A headache with a concurrent red, painful eye.
In the presence of any of these symptoms, seeking immediate medical care is crucial.
Other urgent symptoms include:
Confusion or change in mental status.
Facial drooping or paralysis on one side of the body.
Seizures.
A severe headache in someone with a compromised immune system due to conditions like HIV or cancer.
Sudden onset of extreme pain.
Visual disturbances not caused by migraine.
For these symptoms, one should call emergency services rather than trying to reach the hospital by themselves.
While a headache could be an indicator of a severe medical condition, it is often accompanied by other significant symptoms.
The following details provide insights into the symptoms, considerations, and possible treatments for conditions presenting with a headache as an emergency.
In adults
listed below are certain scenarios where it may be necessary to seek urgent medical care due to a headache.
Heat-related illnesses like heat exhaustion occur due to an excess loss of water and electrolytes, primarily through prolonged heavy sweating.
This condition typically manifests with symptoms such as:
- Throbbing headache
- Vertigo sensations
- Nausea feelings
- Irritation or restlessness
- General bodily weakness
- Intense thirstiness
- Elevated body heat may be observed with a thermometer
- A notable decrease in urine frequency or amount
- Profound and continuous sweating
As highlighted by the United Kingdom’s National Health Service (NHS), heat exhaustion can generally be managed within 30 minutes if the individual is properly cooled down and isn’t considered a dire situation. Nevertheless, it potentially could escalate to heatstroke, which necessitates urgent medical help.
Heatstroke is a critical condition emerging when the body can’t cool off by itself. This can lead to body temperatures swiftly skyrocketing to dangerous levels in as little as 10–15 minutes, presenting life-threatening risks if not promptly addressed.
The key warning signs of heatstroke encompass:
- A confused state, possibly difficulty speaking clearly
- A dramatically altered state of consciousness or behavior
- Excessively hot skin that might feel dry to the touch
- Unusually intense and prolonged perspiration
- Convulsions or muscle twitching
- An extremely high fever
In cases of suspected heatstroke, it is imperative to dial 911 right away for urgent medical aid.
Simultaneously, it is crucial to relocate the person to a cooler space, remove excess clothing, and try to cool them down.
When dealing with heat exhaustion specifically, individuals should:
- Seek a cool environment
- Rest in a reclined position with their feet elevated marginally
- Stay hydrated with ample water intake
For individuals facing either heat exhaustion or heatstroke:
- Apply cool water to the body directly or use a damp cloth
- Facilitate air flow around them with a fan
- Utilize cold, damp towels or ice packs, particularly targeting the head, underarms, and groin regions to expedite body temperature reduction.
Brain tumor headaches
Headaches can often be a sign of a brain tumor, as these growths comprise abnormal cells that multiply in the brain. The rigidity of the skull means it cannot expand to accommodate such growth, which leads to various symptoms, including headaches.
These headaches might indicate the progressive growth of the tumor. Additionally, seizures might be experienced.
Beyond headaches, frequent symptoms associated with brain tumors include:
seizures
visual disturbances
nausea
vomiting
dizziness or balance issues leading to falls
The exact symptoms can differ depending on the tumor’s specific location within the brain.
Management
Management strategies are determined by the tumor’s position and the extent of its proliferation. Possibilities comprise surgical excision, or employing radiation or chemical therapy to reduce the tumor’s size.
In pregnancy
During pregnancy, headaches should be taken seriously as they could signal conditions that might be harmful to both the mother and the unborn child.
These conditions incorporate:
- Preeclampsia
Characterized by elevated blood pressure exceeding 140/90 mm Hg beyond the 20-week threshold of pregnancy, preeclampsia can lead to additional signs such as edema and proteinuria, the latter being an excess protein in the urine as noted by the National Institutes of Health (NIH)Trusted Source.
The progression of preeclampsia can result in eclampsia, a severe and potentially fatality-inducing condition. It can also give rise to HELLP syndrome — a compound acronym for hemolysis, elevated liver enzymes, and low platelet count.
Postpartum preeclampsia is also possible.
Discover further details about postpartum preeclampsia here.
Besides a headache, other symptoms might include:
- Elevated blood pressure
- Visual changes
- Upper abdomen discomfort
- Nausea
- Vomiting
Management Approach
When the pregnancy has reached 37 weeks or moreTrusted Source, medical professionals might opt for inducing childbirth.
For pregnancies at an earlier stage, measures might include thorough monitoring, bed rest, managing blood pressure, and administering medication intended to accelerate the baby’s lung maturation aiding in an earlier labor.
Diagnosis
When diagnosing headaches, the initial step for a doctor is to discern if it’s a primary or secondary headache. A primary headache is an ailment in itself, not a symptom of another underlying issue. Contrastingly, secondary headaches are indicative of another condition.
To identify triggers for primary headaches, patients might be advised to keep a headache diary, noting down potential factors such as diet or activities.
During a medical evaluation for headaches, the doctor will gather a comprehensive medical history and inquire about the headache’s regularity, intensity, and specific site.
For a more accurate diagnosis, medical imaging tools can provide insight into the root of the headache discomfort.
Among these diagnostic methods are:
- An ESR or erythrocyte sedimentation rate blood test to detect inflammation
- MRI, or magnetic resonance imaging, scans
- CT, or computed tomography, scans
- Digital subtraction angiography, a process combining X-ray imagery with the use of iodine to get a visual of the brain’s blood vessels
- A spinal tap to gauge the presence of infection or any bleeding within the brain
Summary
While headaches are typically benign, they can sometimes signal a critical condition.
Should there be uncertainty regarding the severity of a headache, it is advisable to err on the side of caution and obtain urgent medical care.
Healthcare professionals are equipped to assess the situation and prescribe interventions to alleviate headache symptoms and tackle any root issues.
