Headaches are often treatable at home and not a cause of worry, but some need urgent medical attention. For instance, a sudden, severe, thunderclap-type headache can be a sign of a stroke.
Among those who seek treatment at an emergency department, around
This article looks at the different causes and symptoms of potentially dangerous headaches. It also looks at when a person should seek medical help.
The following are some symptoms that indicate a person should seek immediate medical treatment related to their headache:
- a severe headache that becomes unbearable within seconds to minutes
- a headache that starts or changes intensity when changing position
- a headache that begins when a person coughs, sneezes, or strains themselves
- a headache that does not go away
- a headache that develops after 50 years of age
- a headache that occurs with symptoms including fever, chills, night sweats, and unexpected weight loss
- a headache that begins despite the person having no history of headache or migraine
- a significant increase in the frequency of headaches or a change in the headache’s characteristics
- a constant headache that always occurs in the same location
- associated neurological symptoms, such as changes in vision, numbness or weakness on one side of the body, or speech changes
- accompanying red and painful eye
If a person experiences any of these symptoms, they should seek medical help immediately.
A person should also seek immediate medical help if they experience:
- an altered mental state
- facial drooping or an inability to move one side of the body
- seizures
- a severe headache and they have a history of immunosuppression due to a medical condition such as HIV or cancer
- the sudden onset of severe, unbearable pain
- visual disturbances unrelated to migraine
If a person experiences any of these symptoms, they should call 911 for emergency medical attention. They should not attempt to drive themselves to the emergency room.
A headache can indicate a number of emergency medical conditions. However, this is not typically the only symptom a person experiences.
The following are symptoms, considerations, and treatment options for emergency headache conditions.
The following sections describe some emergency-related reasons a person may need to seek medical attention for a headache.
Heat exhaustion and heatstroke
A person experiences heat exhaustion as a result of the excessive loss of salt and water. This
Symptoms include:
- headache
- dizziness
- nausea
- irritability
- weakness
- thirst
- raised body temperature
- decreased output of urine
- heavy sweating
The United Kingdom’s National Health Service (NHS) notes that if a person cools down within 30 minutes, heat exhaustion is not serious. However, it can develop into heatstroke, which is a medical emergency.
Heatstroke occurs when the body is no longer able to regulate its temperature. When a person experiences heatstroke, their temperature may rise quickly,
Symptoms of heatstroke include:
- confusion, slurred speech
- altered mental state
- hot, dry skin
- profuse sweating
- seizure
- very high body temperature
Treatment
If a person notices someone nearby is exhibiting the symptoms of heatstroke, they should immediately call 911 for intervention.
They should then move the person to a shady, cooler area and take off outer layers of clothes.
If a person is experiencing heat exhaustion, they should:
- move to a cool place
- lie down and slightly raise their feet
- drink plenty of water
For both heat exhaustion and heatstroke, a person should spray the skin or sponge it using cool water.
They could use a fan to circulate air to help aid cooling. Cold, wet cloths or ice on the head, armpits, or groin can help with cooling.
Brain tumor
A brain tumor occurs when abnormal cells grow and divide in the brain. Because the skull does not allow for significant brain expansion, the tumor’s presence can cause a number of symptoms, including headaches.
Headaches may represent the brain tumor’s growth. Some people also experience seizures.
In addition to headaches, the
- seizures
- an altered mental state
- visual changes
- nausea
- vomiting
- dizziness or falls
The specific symptoms may vary based on the location of the tumor.
Treatment
Treatment depends on the location of the tumor and whether or not it has spread. Options may include surgical removal, or radiation or chemotherapy to shrink the tumor.
Learn more about the different types of brain tumors and the treatment options available here.
Carbon monoxide poisoning
Carbon monoxide is an odorless, colorless gas that occurs when a person burns fuel in an automobile, stove, small engine, lantern, grill, fireplace, gas range cooker, or furnace.
An estimated
Carbon monoxide has a
Additional symptoms of carbon monoxide poisoning include:
- dizziness
- weakness
- nausea
- vomiting
- confusion
- chest pain
Some people who are sleeping or have been drinking alcohol may not experience symptoms, which can
Treatment
After exposure to carbon monoxide, a person should get to fresh air as quickly as possible and call 911.
Healthcare professionals will treat carbon monoxide poisoning using oxygen and a medication called methylene blue, which they administer through an intravenous (IV) line.
Carotid artery dissection
Around
The condition occurs when there is a tear in the layers of one of the carotid arteries that supply blood to the brain. As a result, blood can pool within the layers of the artery.
A carotid artery dissection can lead to stroke, brain damage, and death.
The headache that develops due to carotid artery dissection typically only affects one side of the head, according to a case study in
A person may also experience neck pain, speech changes, and a slight drooping of one eye.
Treatment
Treatment will depend on the symptoms and where in the carotid artery the dissection has occurred. Options typically include:
- taking blood-thinning medications
- undergoing endovascular treatment
- undergoing surgery
Learn more about carotid arteries here.
Concussion
A concussion is a brain injury that occurs due to a blow or jolt to the head. The movement affects the brain’s positioning in the skull and can lead to brain cell damage.
If a person does not receive treatment, this can lead to brain damage, seizures, and death.
A headache or neck pain are common symptoms of concussion.
Other symptoms include:
- nausea or vomiting
- ringing in the ears
- dizziness
- tiredness
- convulsions
- confusion
- weakness, numbness, or decreased coordination
- sensitivity to noise or light
- slurred speech
- fainting
Treatment
Treatment includes resting and limiting physical activity to allow the brain to heal.
Treating the symptoms is also vital. For example, a primary care doctor or a neurologist should treat a headache early, and a psychiatrist should treat any feelings of depression or anxiety as soon as possible.
If a person has a hematoma, or a collection of blood outside of a blood vessel, they may require surgery to evacuate or reduce it.
Hypertensive crisis
A hypertensive crisis occurs when a person’s systolic blood pressure is higher than 180 millimeters of mercury (mm Hg) or their diastolic blood pressure is higher than 120 mm Hg, according to the
If a person does not receive prompt treatment, a hypertensive crisis can cause life-threatening conditions such as stroke, heart attack, pulmonary edema, or an aortic dissection.
A headache is a common symptom when a person has high blood pressure, according to a long-term study in the American Journal of Hypertension.
Other symptoms may include shortness of breath, nosebleeds, and profound anxiety.
Treatment
A doctor may admit a person experiencing a hypertensive emergency to the hospital.
Treatments include medications such as beta-blockers, thiazide diuretics, angiotensin receptor blockers, and angiotensin-converting enzymes.
Learn more about managing hypertension here.
Meningitis
Meningitis is an infection of the outer layers of the brain. It can develop due to a previous infection in the inner ear, sinuses, or another area of the body.
Untreated meningitis can lead to sepsis, which is a severe infection in the body that causes the organs to shut down.
As well as a headache, symptoms of meningitis include:
- fever
- a stiff neck
- nausea
- vomiting
- sensitivity to light
Treatment
Doctors will typically treat meningitis using antibiotics.
Stroke
There are two main types of stroke — ischemic and hemorrhagic. An ischemic stroke can occur when a blood clot lodges in a vessel in the brain. A hemorrhagic stroke can occur due to bleeding in the brain.
If a doctor cannot treat the stroke promptly, a person can develop significant disabilities or die. Anyone experiencing a stroke needs immediate medical attention.
Some additional symptoms include:
- facial drooping
- changes in the person’s mental state
- weakness on one side of the body
- numbness on one side of the body
- vomiting
- speech changes
Treatment
Treatment depends on the type of stroke.
Options include taking medications to break up a clot and surgery to remove a clot or repair a damaged blood vessel.
People should not ignore headaches during pregnancy as they might indicate a potentially serious condition that could affect their own or their baby’s health.
These conditions include the following:
Preeclampsia
This is a condition that causes high blood pressure greater than 140/90 mm Hg after 20 weeks of pregnancy. It can also cause swelling and proteinuria, or the presence of protein in the urine, according to the
Preeclampsia can progress to eclampsia, which is a life-threatening condition. It can also lead to a condition called HELLP syndrome. HELLP stands for hemolysis, elevated liver enzymes, and low platelet counts.
A person can also experience preeclampsia in the immediate postpartum period.
Learn more about preeclampsia after birth here.
As well as a headache, some symptoms include:
- high blood pressure
- vision changes
- pain in the upper abdomen
- nausea
- vomiting
Treatment
If a pregnancy is at
Pregnancies that are not as far along may require frequent monitoring, bed rest, blood pressure treatments, and medications to help speed up fetal lung development and aid earlier delivery.
Eclampsia
Eclampsia is a severe form of pregnancy hypertension that can result in seizures or a coma. It can be life-threatening to both the pregnant person and the fetus. It can also lead to HELLP syndrome.
Besides a headache, symptoms may include:
- high blood pressure
- seizures
- a coma
- nausea
- vomiting
- sensitivity to light
Treatment
Immediate intervention is needed to prevent life-threatening complications.
Examples include administering magnesium sulfate via an IV line to
Doctors may also make every effort to deliver the baby.
In the immediate postpartum period, a person can also experience a severe headache known as a postdural puncture headache (PDPH) if they had an epidural or spinal anesthesia for pain management.
According to a 2017 article, however, around
- caffeine consumption
- bed rest
- analgesic medications
A doctor may also offer a blood patch as a treatment.
Headache and migraine resources
To discover more evidence-based information and resources for headaches and migraine, visit our dedicated hub.
Children can also experience severe headaches that may indicate a medical emergency.
These include:
Concussion
According to the
A
Meningitis
Symptoms of meningitis in babies and newborns include headaches, inactivity, irritability, difficulty feeding, or vomiting.
A doctor will seek to determine whether the headache is primary or secondary. A primary headache is not a symptom of another condition. Secondary headaches are symptoms of other, underlying conditions. A headache diary may help determine the triggers for primary headaches, such as food or activities.
A healthcare professional will take a full medical history when examining a person for headaches. They will also ask questions about the frequency, severity, and location of the headaches themselves.
Diagnostic tools such as imaging may help the doctor determine the source of headache pain.
Some options are:
- erythrocyte sedimentation rate (ESR), a blood test that indicates inflammation
- MRI scan
- CT scan
- digital subtraction angiography, which uses X-ray and iodine to map blood vessels in the brain
- spinal tap, which can determine if infection is present or if there is bleeding in the brain
Although usually harmless, a headache might indicate an emergency situation.
If a person is unsure whether or not their headache is a symptom of a serious or life-threatening condition, they should seek emergency medical attention.
A doctor can evaluate their condition and recommend treatments to reduce their headache and address any underlying causes.