Headaches are very common. From tension headaches to migraines, your average GP will see a few patients with a headache every day, and most are nothing to worry about. But there are a few warning signs that doctors look out for, which may mean your headache is more serious, and needs more investigating. Here are 5 of the “red flags” that should never be ignored.
A “Thunderclap Headache”
If a headache comes on very suddenly and severely, it may be a subarachnoid haemorrhage. This is a serious bleed in the brain, which can be fatal. Early diagnosis can be life-saving. People who have had this type of headache often say it felt like a blow to the back of the head- the worst headache of their life. Some people lose consciousness immediately. It’s a medical emergency, so an ambulance should be called.
Fever and rash
A new headache with a high temperature can be a sign of meningitis- an infection of the tissue that lines the brain and spinal cord. The person will usually feel very unwell, and may develop vomiting, sensitivity to light, and a stiff neck. If the infection spreads through the body, a “petechial rash” may occur. This rash looks like spots of blood under the skin- and they don’t go away when you press them. Meningitis can kill, and is a medical emergency- anyone with these symptoms should seek immediate medical attention.
Daily headaches that are worse in the morning
If a headache is happening most days and is worse in the morning, this can be a sign of raised pressure in the brain. As a person stands up during the day, the pressure is relieved and the headache eases, but it gets worse again through the night when they lie down. This increase in pressure can be caused by a variety of conditions, some of which are serious- including brain tumours. A brain scan may be needed.
Weakness in the face, arm or leg
If a person gets a headache at the same time as weakness in the face, arm or leg, this can be a sign of a stroke. Sometimes speech or eyesight may be affected, and vomiting and confusion may occur. Some forms of migraine can cause symptoms like this, but if you’ve never had these symptoms before, or you’re not sure, it should be viewed as an emergency, and an ambulance should be called.
Tenderness in the scalp
Lots of people who get headaches experience a bit of scalp tenderness. But if your temples are unusually tender and sore, this can be a sign of “temporal arteritis”. In this condition, there is inflammation in some of the blood vessels that supply the head. It needs to be diagnosed and treated quickly, because it can lead to blindness and stroke. A blood test may be required for diagnosis, and sometimes a biopsy (sample) of the scalp blood vessels. It’s rare before the age of 55, and more common in women than men.
If you’ve any worries about headaches, be sure to speak to your doctor.
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Clinical review & governance
Medically reviewed by Dr AIFRIC BOYLAN
CEO
About Dr Aifric Boylan MB BCh BAO MICGP FRACGP DRCOG DCH Fellow of the Royal Australian College of General Practitioners, Dr Aifric Boylan is a general practitioner with more than 20 years' experience. She graduated in medicine from…
This health information has been clinically reviewed by an Australian doctor. Qoctor health pages are reviewed to support clear, evidence-informed guidance; they do not replace individual medical advice.
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