Among those who seek treatment at an emergency department, around 0.5% to 4.5% do so for a headache that is not related to trauma, according to an article in the journal PLOS ONE.
This article looks at the different causes and symptoms of potentially dangerous headaches. It also looks at when a person should seek medical help. ‘Red flag’ symptoms
The following are some symptoms that indicate that a person should seek immediate medical treatment related to their headache:
- a very 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 occurs with symptoms including fever, chills, night sweats, and unexpected weight loss
- a headache that begins despite the person having no history of headache pain 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
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 in a person who has a history of immunosuppression, due to medical conditions 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 department.
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.
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 most common brain tumor symptoms in people going to the emergency department are:
- 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 where the tumor is located and whether or not it has spread. Options may include surgical removal or radiation or chemotherapy to shrink the tumor.
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 20,000 people per year visit the emergency room due to carbon monoxide exposure, according to the Centers for Disease Control and Prevention (CDC).
Carbon monoxide has a greater attraction to cells than oxygen in the bloodstream. As a result, carbon monoxide molecules can replace oxygen, which can ultimately lead to suffocation and death.
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 increase the fatality risk of carbon monoxide exposure.
Treatment
With 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 will administer through an intravenous (IV) line.
Carotid artery dissection
Around 68% of people with carotid artery dissection will experience headaches, according to a case study in the journal BMJ Case Reports.
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 BMJ Case Reports.
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
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 is the most common symptom of concussion, according to a case study in the journal Sports Health.
Other symptoms include:
- memory loss
- clumsy movements
- a loss of consciousness
- personality changes
- pupils that are different in size
- confusion
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 American Heart Association (AHA). A sudden or significant increase in blood pressure may cause headaches.
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.
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.
According to an article in Nursing Times, a hemorrhagic stroke is more likely to cause headaches than an ischemic stroke. However, a person can experience a headache in both types.
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.
More treatment process for stroke are shared here
Women should not ignore headaches during pregnancy, as they might indicate a potentially serious condition that may affect their 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 National Institutes of Health (NIH).
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 woman can also experience preeclampsia in the immediate postpartum period.
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 37 weeks or later, a doctor may recommend delivering the baby.
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 to 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 woman 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 reduce the risk of seizures, and taking medications to lower blood pressure.
Doctors may also make every effort to deliver the baby.
In the immediate postpartum period, a woman 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 85% of PDPH cases resolve by themselves with conservative treatment, including:
- caffeine consumption
- bed rest
- analgesic medications
A doctor may also offer a blood patch as a treatment.
Children can also experience severe headaches that may indicate a medical emergency.
These include:
Concussion
According to the CDC, toddlers and infants may show different concussion symptoms than adults. As well as a headache, these may include a refusal to nurse or eat, persistent crying, and an inability to be consoled.
According to a 2017 article, people should not give aspirin to anyone younger than 16 years, due to increased risks of bleeding and a condition known as Reye’s syndrome.
Meningitis
Symptoms of meningitis in babies and newborns include headaches, inactivity, irritability, difficulty feeding, or vomiting. Sometimes, their head may appear to bulge through the soft spot.
Summary and Conclusion
Though 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.
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