Ordinary headaches are part of the normal human experience. However, a headache that is severe, persistent or associated with other symptoms such as vomiting and confusion is a warning signal to a dangerous problem.
“Worst Headache of Your Life”
Pain in the head or upper neck is one of common locations of pain in the body and is attributed to many causes. The “worst headache of your life” is a term found in medical textbooks to describe the pain associated with a subarachnoid hemorrhage caused by a ruptured cerebral aneurysm. The headache occurs while the person is lying still and is associated with a stiff neck, difficulty tolerating light in a room, vomiting and confusion. Usually the first headache is a warning sign. The initial subarachnoid hemorrhage is not fatal. If immediate medical attention is sought, the aneurysm can be detected and surgically repaired. If the symptom is ignored, the next bleed can be catastrophic.
Headaches That are Worse in the Morning
A headache that is worse in the morning, improves after the person vomits, gradually improves as the day progresses and worsens with coughing, exercise, bending or kneeling is a common symptom of a brain tumor. This type of headache does not respond to usual headache remedies. However, Casilda Balmaceda, M.D., an Assistant Professor of Neurology at Columbia University College of Physicians and Surgeons in New York City, states that only about eight percent of all patients with a brain tumor have headache as the first and only symptom. She points out that most brain tumors manifest with other symptoms such as altered mental status and seizures. Metastatic brain tumors are more frequently associated with the symptom of a headache than primary brain tumors. Other symptoms of a brain tumor often mimic other conditions. It is important to seek medical evaluation if you experience this type of headache or other symptoms that are unusual for you.
Severe Headache of Sudden Onset
A headache that occurs suddenly, is severe and appears to have no known cause is a reason for concern. If it is associated with sudden numbness or weakness in the face, arm or leg and only one side of the body is affected, this is a warning sign of a stroke. Additional symptoms of a stroke include sudden onset of confusion, trouble speaking and understanding, difficultly seeing in one or both eyes, trouble walking, dizziness, and loss of balance. A person who experiences these symptoms must seek immediate emergency medical attention.
Severe Headache with Stiff Neck and Fever
A severe headache that is associated with a stiff neck, high fever, nausea and vomiting warns of meningitis. Meningitis is the inflammation of the meninges, which are the membranes that surround the brain and spinal cord. Additional symptoms of meningitis are confusion, seizures, sleepiness, sensitivity to light, loss of appetite, and in some cases, a skin rash. This is a medical emergency that requires immediate medical attention.