The Skinny on Headaches
More than 9 out of 10 adults will experience headaches in their lifetimes. It is the most common form of pain and, when left untreated, can interfere with daily activities at work and at home. Headaches are often cited as reasons for missing work, school and special events, and can range from mild tension headaches to agonizing cluster headaches, sometimes called suicide headaches.
There are two classifications for headaches: primary headaches, which occur independently and are not caused by another medical condition. Migraine, cluster and tension headache are some common forms of primary headache. Secondary headaches are symptoms of another health disorder and are caused by pain-sensitive nerve endings being pushed or pulled out of place. Headaches can arise from conditions like fever, infection, stress, high blood pressure, psychiatric disorders, head trauma, stroke, tumors or nerve disorders.
According to Dr. Andrew Bauer with the Cleveland Clinic in Florida, “Headaches are a fairly common occurrence, but experiencing a sudden, severe headache could be a sign of a more serious, life-threatening condition. Up to 6 percent of the population could be living with an unruptured brain aneurysm, while an estimated 300,000 people will experience a brain aneurysm within the next year. The key to overcoming a brain aneurysm is early detection and interventional treatments.”
Because secondary headaches can be early warning signs of life-threatening conditions, like aneurysm or stroke, it’s important to seek medical attention when your headache feels unusual. In the case of stroke, for example, doctors have what is called a “Golden Hour” when treatments will be most effective at minimizing and reversing the stroke's damage. Putting off medical treatment in the case of something like stroke means putting yourself at risk for more serious or permanent damage or death.
Should I See a Doctor?
Most headaches may not be serious and will resolve themselves given time, home remedies or over-the-counter medications, like Tylenol. However, there are times when headaches are indications that your body is in need of medical attention. Some of us may have reservations about scheduling an appointment with our doctors or visiting the ER (e.g., “It’s JUST a headache.”), but according to the National Institute of Neurological Disorders and Stroke, the following symptoms warrant an appointment with your physician:
● You have more than just the occasional headache
● Your headaches are severe or come on quickly
● Your headache is accompanied by confusion, dizziness, fever, numbness, persistent vomiting, shortness of breath, slurred speech, stiff neck, diarrhea, vision loss, weakness or unpredictable symptoms affecting your ears, nose, throat or eyes.
● You have a headache that persists for 72 hours, with no more than a 4-hour pain-free window during waking hours, or a headache that continues to get worse
● Your headaches began after a head injury or other trauma and have continued.
According to the American Headache Society, headache sufferers should remember the acronym “SNOOP” when determining whether their headaches warrant medical attention, which stands for:
Systemic symptoms and Secondary risk factors: In addition to your headache, if you feel symptoms in other parts of your body, including fever, loss of appetite or weight loss, or if you have a headache in addition to HIV, cancer or other disorder, call your doctor immediately.
Neurologic symptoms: If you have headache accompanied by confusion, blurry vision, personality changes, weakness on one side of the body, numbness or sharp facial pain, you should seek medical attention.
Onset: If your headache comes on suddenly without warning or typical trigger, seek immediate medical attention. These headaches are sometimes called “thunderclap” headaches and can indicate bleeding in the brain.
Older: While headaches could be a sign of a larger medical problem at any age, if you are older than 50 and experience a new or progressive headache, you should call a doctor. Headache sufferers who are 50 or older are at higher risk for tumors and giant cell arteritis, which could cause a headache.
Progression: If your headache is significantly different from your regular headaches, increase in frequency, or you describe it as the worst headache you’ve ever had, seek immediate medical attention.
Go to the ER
While many types of headaches can be addressed with a visit to your primary care physician or neurologist, there are some symptoms that should always warrant a trip to the emergency room for immediate attention. If any of the following apply, stop reading and head out the door:
● You are having the worst headache or migraine attack ever
● A child is having recurring headaches
● Your headache is accompanied by unresolved loss of vision, loss of consciousness or uncontrollable vomiting
● Your headache pain lasts for more than 72 hours with less than a solid four-hour, pain-free window while awake
● You experience a headache or migraine attack that presents abnormal, frightening symptoms.
Headaches in Children
The National Institute of Neurological Disorders and Stroke says that two out of every three children will experience a headache by the age of 15. While most headaches in children are primary headaches, you should consult your child’s pediatrician if headaches are frequent or severe or if they include unusual symptoms. Among these symptoms, parents should be on the lookout for headaches that are accompanied by:
● Severity to the point where it wakes the child from sleep
● Early-morning vomiting without nausea
● Headaches that increase in frequency or severity
● Personality changes
● Headaches that are markedly different from previous headaches
● Headaches with fever or a stiff neck
● Headaches that follow an injury
● Complaints that this headache is the most severe that the child has ever had
Whether it's you or your child experiencing the misery of headaches, learn the symptoms that could save a life.