Headache After 50? Here Are Some Possible Causes

New Headaches Can Be a Sign of Something More Serious

brain_tumor.jpg
Brain Pathology.

Migraines rarely begin anew in older people. Only three percent of migraine sufferers (specifically migraine with a headache) are first diagnosed after 50 years of age. And, in fact, migraines tend to improve with age. Moreover, after 45, the new onset of cluster and tension headaches—the other two types of primary headache—is rare, too. That, of course, doesn't mean that new headaches after age 50 don't happen.

 It simply means that the chances of them being secondary to something else skyrockets.

Secondary Causes of Headache

Many of the potential causes of new headache after age 50 are, unfortunately, serious. It's important to remember, though, that a symptom of something doesn't mean that you have that something.

Regardless, you are encouraged to see your physician if you're experiencing persisting and/or severe headaches. He or she may explore more benign causes like intense stress or postural issues, but also some of these health concerns:

Intracranial hemorrhage: There are several types of brain hemorrhages or bleeds that are characterized by anatomy:

  • Subdural hematomas
  • Subarachnoid hematomas
  • Epidural hematomas
  • Intracerebral hemorrhage (a true medical emergency that requires immediate CT and surgery; think clipping of an aneurysm)

Older people are at increased risk for developing brain bleeds. Furthermore, sometimes these bleeds are triggered by an injury such as an accidental fall.

Some types of brain bleed are slow and a person can retain consciousness for a while. In this period, for example, an elderly woman can maintain conversations, drive a car, or run a company.

Giant cell arteritis: Giant cell arteritis is a systemic or body-wide vasculitis that attacks the temporal artery (hence its alternative name, temporal arteritis).

 Temporal arteritis is a medical emergency; if not treated in time, it can cause blindness. It usually affects white woman older than 50 and presents as a throbbing over the temples.  

Mass lesion: Older people are more at risk for a brain tumor (brain cancer). The hydrocephalus from a growing tumor can compress the brain and brain system. This compression results in brain damage and death. Up to 50 percent of people with brain tumors complain of a generalized pain that can localize over the lesion. An MRI is needed to confirm the diagnosis.

Trigeminal neuralgia: The incidence of trigeminal increases with age. Trigeminal neuralgia occurs when the small blood vessels of the face cross with the trigeminal nerve. People are left with trigger points that set off intense pain that can last anywhere from two seconds to two minutes. Trigeminal neuralgia is treated with the anticonvulsant Tegretol (arbamazepine)

Listen to your body and inform your physician of how you're feeling early on. Again, your head pain may be cause for concern, but not necessarily alarm.

On the other hand, if one of these issues is affecting you, learning about it sooner than later can not only be beneficial, but potentially life saving.

Please keep in mind that the content in this article is not meant to scare you in any way. It's just meant to provide you important information that could possibly save the life of you or a loved one. Making an appointment with your physician if you're concerned about headache or any other problem is always a good idea. Your physician is there to help you and guide down the path of good health. Even something that seems relatively trivial, like a headache, can be indicative of something more. 

Sources:

Anderson K, Wold J. Treating Headaches in Older Adults. In: Current Diagnosis & Treatment: Geriatrics, Second Edition. New York, NY: McGraw-Hill; 2014. Accessed February 06, 2015.

Ropper AE, Ropper AH. Chapter 209. Intracranial Hemorrhage and Related Conditions. In: Principles and Practice of Hospital Medicine. New York, NY: McGraw-Hill; 2012.  Accessed February 06, 2015.

Usatine RP, Smith MA, Chumley HS, Mayeaux EJ, Jr. Chapter 231. Subdural Hematoma. In: The Color Atlas of Family Medicine, 2e. New York, NY: McGraw-Hill; 2013.  Accessed February 07, 2015.

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