These are the times when you should be worried.
1. Fever – if your temperature is going up and you have a headache it could just mean that you have a bad head cold or the flu. OR, it could mean that you have meningitis or encephalitis. If your fever and headache are accompanied by a stiff neck, confusion, lethargy, vomiting or a skin rash, you might have to get in line for a spinal tap.
2. A sudden, severe headache – if you get a really bad headache very suddenly, especially if it is limited to one part of the head, you could have an aneurysm that is about to rupture or that has ruptured. Since 50% of ruptured aneurysms are fatal, you should get to an emergency room. I was taught that if a patient comes into the ER saying that they have the worst headache of their life, I should immediately think aneurysm and proceed accordingly. If the sudden, severe headache is accompanied by a stiff neck, nausea and vomiting, blurred vision, a drooping eyelid, a dilated pupil or a personality change, drive to the ER faster. Actually, 911 is probably a better call at this point.
3. Maybe it is a tumor – each year in the U.S., about 22,000 people are diagnosed with a brain tumor. A brain tumor can present as almost any type of a headache but it usually presents with other symptoms as well. These symptoms are most often reflective of the part of the brain that is housing the tumor and include weakness or loss of sensation on one side of the body, clumsiness, difficulty walking, loss or changes in vision. A seizure is, very frequently, the first sign of a brain tumor that prompts medical attention.
4. Stroke – a stroke, like a heart attack happens suddenly. It does not always cause a headache but when it does, the pain will be sudden and severe. It may be accompanied by the following symptoms which would also appear suddenly: confusion or a personality change, numbness or weakness on one side of the body, loss of vision in one or both eyes, loss of balance. The best chance you have to survive a stroke is immediate medical attention in a hospital. If you or a loved one have these symptoms, don’t wait. Even if someone you don’t care for very much has these symptoms, at least hand them your cell phone.
5. Headache in children – the most beautiful thing about children, with the exception of bedtime, is that when they are sick, they are sick and when they are well, they are well. There is no in-between. Adults have so much to complain about that it is never quite clear, even to the patient, if they are feeling better. If it weren’t for the crazy parents (and lets face it, all parents are crazy), I would have been a pediatrician because kids are so easy to read. If your child tells you they have a headache, pay attention. Kids can get all the same types of headaches as adults and most likely their headache is nothing to worry about. But, if they exhibit any of the symptoms described in 1-4, get immediate help. If their headache is following an injury, get immediate help. If their headaches are occurring at least once a month, seem to be getting worse, or are causing you to lose sleep, make an appointment to see your pediatrician or family doctor. I know if you have children you are thinking about this, so … about 1500 (out of 75 million) children are diagnosed with a brain tumor each year in the U.S.
Obviously infants cannot tell you they have a headache but constant crying, high fever, lethargy, overall stiffness, a bulging fontanelle, and of course, seizure, should alert you that something very serious is going on.
I am sure it is mind over matter but I have had the worst headaches all week. No, “mind over matter” is not the name of a wine, although I do think it would be a good one. So, I have had ample time to pinpoint five things that really give me a headache … tomorrow I vent. Feel free to drop a comment on what gives you a pain in the head!