Worrisome Headache Symptoms
Some headaches are more concerning than others. Please review the worrisome headache symptoms below. If you have any of these symptoms, don't panic, but do contact your physician regarding them.
Headaches associated with weakness, numbness, or visual changes are more worrisome. This could be the hallmark of a stroke, tumor, or other problem within the brain. The context is very important. If you have had the symptoms for years - in a recurrent manner - then likely the cause is benign (for example, migraine headaches can lead to such symptoms). On the other hand, if the symptoms have occurred only once, then you should discuss them with your physician.
Headaches that occur daily and that are getting worse week after week can be due to brain tumors or other mass lesions in the brain. In this setting, headaches may also worsen with exertion, coughing, or straining. These should be discussed with your physician and appropriate testing (CT scan or MRI) should be ordered. Although this testing must be performed before concluding that these are not worrisome headache symptoms in your case, another cause for these symptoms can be a (more) benign condition of increased pressure in the brain called
pseudotumor cerebri.
A headache that comes on suddenly and severely, and that would be described as the worst headache of your life, without a history of similar such headaches, is very worrisome. This is a classic symptom of a ruptured brain aneurysm (see graphic) which leads to bleeding around the brain (a
subarachnoid hemorrhage
). This is a medical emergency and should be treated as such. It can be associated with neck stiffness, confusion and inability to stay awake, along other neurological symptoms.
A headache that has developed over the last 12-24 hours that is associated with fever and neck stiffness is a worrisome sign. A person must be concerned about
meningitis
in this setting. This would not apply to someone who chronically suffers from headaches and neck stiffness who also happens to be ill from another cause (such as an upper respiratory infection, influenza, or other type of infection).
Headaches that are persistent and daily in someone older than 50 years; especially combined with scalp tenderness at one or both temples, is suspicious for
temporal arteritis
(giant cell arteritis). This is inflammation of the temporal artery, but can involve other arteries. A person may also complain of jaw pain or tiredness while chewing. Especially worrisome is temporary or permanent loss of vision in one eye. These symptoms require rapid evaluation by a physician.
Daily headaches that persist after head trauma may be due to bleeding in or around the brain, and thus constitute worrisome headache symptoms. If, after head trauma, a person experiences dull, daily headaches that are associated with a spinning sensation in the head (vertigo) and poor concentration, this may be due to the more benign condition called
postconcussive syndrome.
Headaches that occur after a spinal tap (lumbar puncture) are often called
spinal headaches
and usually are not worrisome headache symptoms, although they can be severe and may need treatment to eliminate them.
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