When you hear about headaches caused by life-threatening medical conditions, those are secondary headaches, Walavan Sivakumar, MD, director of neurosurgery at Pacific Neuroscience Institute at Providence Little Company of Mary in Torrance, CA, tells SELF. “Secondary headaches have a clear reason why someone is in pain,” Dr. Sivakumar says. “These are the ones that scare people, like pain caused by brain tumors, blood clots, or bleeding in the head.”
Symptoms of primary and secondary headaches can overlap, but Dr. Sivakumar says there are a few telltale signs that you’re dealing with a secondary headache.
Signs your headache may be caused by a medical issue
Again, most headaches aren’t caused by something scary. But there are a few things doctors look out for that can signal a concerning cause behind your head pain. “The big things we’re worried about are bleeding in the brain, meningitis, and certain types of stroke,” Robert Shesser, MD, chair of the Department of Emergency Medicine at George Washington University, tells SELF.
For example, Gadot’s headaches were due to cerebral venous thrombosis (CVT), which is a very rare type of stroke caused by blood clots in the brain. Anyone can develop a blood clot, but women are especially vulnerable to experiencing them during pregnancy and in the postpartum period, according to the CDC. In fact, pregnant women are five times more likely to have a blood clot than those who aren’t expecting. Pregnancy-related clots most commonly occur in the legs and arms, known as deep vein thrombosis (DVT), or travel to the lungs, known as a pulmonary embolism (PE). Gadot’s experience with clots in her brain is extremely rare.
As Mellencamp’s story shows, headaches can also be due to a brain tumor, although this is also “very rare,” Whitney Luke, MD, pain medicine specialist, chair, and clinical professor of physical medicine and rehabilitation at The Ohio State University Wexner Medical Center, tells SELF.
Even still, there are plenty of less-concerning causes of headaches that are still worth getting checked out and treated for. These are the biggest signals you should see a medical professional about your head pain.
You have the worst headache of your life.
This tends to come on hard and fast, Erin Muckey, MD, associate professor of emergency medicine at Rutgers New Jersey Medical School, tells SELF. “The headache reaches peak intensity really quickly,” she says. If you’re experiencing this, Dr. Shesser says it’s important to head to the ER. “This is something you want to be seen quickly for,” Dr. Shesser says. It can suggest a few things, including a ruptured aneurysm, which is a weakened area of a blood vessel in or around your brain that bursts, he says. This is a life-threatening medical emergency.
The headache is different from your usual.
If you already experience headaches, you probably know what does and doesn’t feel normal to you. “A headache that’s new to you that persists is concerning,” Dr. Muckey says. “If you think, ‘This is new. My headaches usually go away when I get a good night’s sleep and that’s not helping,’ it’s worth getting checked out.”
You’re dealing with neurologic symptoms, too.
Having a headache is one thing, but adding other symptoms on top of that like new vision changes, numbness, tingling, weakness, or trouble speaking are a big concern, Dr. Sivakumar says. Among other things, these can be a sign of a stroke. “This is not something people should sit on,” he adds.
OTC medications aren’t helping.
To be fair, over-the-counter medications like acetaminophen (Tylenol) and ibuprofen (Advil or Motrin) don’t help to get rid of all primary headaches, including migraines. But if you usually find that they help with your headaches, but they’re not doing it this time around and your headache isn’t quitting despite trying to treat it, Dr. Sivakumar says it’s time to get an evaluation.
It’s persistent.
A headache that comes on and won’t stop isn’t just painful—it’s a sign that something else may be behind it, Dr. Muckey says. How long to give this depends on how you’re feeling. If things get progressively worse, she says you’ll want to be seen sooner rather than later. But if your headache comes on and is at a consistent but manageable level of discomfort, Dr. Shesser recommends getting it evaluated after a few days to a week (if you can stand it that long).
You have no clue what’s behind your pain.
If you’ve been grappling with work stress, haven’t been eating well, or have been exposed to your known migraine triggers, you probably have a solid idea what’s causing your headache. But if you’re clueless about what’s going on and you’ve tried home remedies like OTC medications and staying well hydrated, to no avail, Dr. Sivakumar recommends seeing a doctor.
Here’s what to expect when you get evaluated.
A healthcare provider should give you a physical exam, which includes looking at your eyes, taking your temperature, and learning more about your history with headaches, Dr. Sachdev says.
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