How A Headache May Be a Sign of a Stroke

Distinguishing a Stroke-Related Headache from a Benign Headache

Can a Stroke Cause a Headache?
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A stroke is a medical emergency that may also be associated with a headache. Let's read about the types of stroke and how a stroke-related headache may be distinguished from a benign primary headache.

What is a Stroke?

Strokes, or "brain attacks," occur when blood flow to the brain is interrupted. There are two types of strokes. An ischemic stroke occurs when an artery that supplies oxygen-rich blood to the brain becomes blocked — this causes brain cell death due to lack of blood flow.

A hemorrhagic stroke occurs when an artery in the brain bursts, and there is bleeding into the brain. A common example of a hemorrhagic stroke is a subarachnoid hemorrhage — and in this condition, a severe headache is the only symptom in about a third of the patients.

Both types of strokes are medical emergencies, and both may be associated with a headache.

What is the Most Common Type of Headache in Stroke?

According to an older study in Stroke, the most common type of headache is a tension-type headache.

The location of a headache may depend on where the stroke is occurring. For instance, strokes that arise within the carotid artery — a major artery in the neck that brings blood to the brain —may produce a forehead headache. Strokes in the vertebrobasilar system, which supplies blood to the back of the brain, may produce a headache at the back of the head.


Distinguishing Strokes from “Normal” Headaches

It depends upon which type of stroke a patient is experiencing, but according to a 2010 study in the Handbook of Clinical Neurology, between 7 to 65 percent of stroke victims report some sort of headache.

If you experience any of the following symptoms with your headache, you may be having a stroke:

  • You feel you are having “the worst headache of your life”
  • A “thunderclap headache” (an abrupt, severe headache without warning)
  • Weakness of the face, arm, and/or leg on one side of body
  • Numbness in the face, arm, and/or leg one side of body
  • Inability to understand spoken language
  • Inability to speak
  • Inability to write
  • Vertigo and/or gait imbalance
  • Double vision

What Should You Do?

If you believe you are having a stroke you should call 911. Early treatment is the key to preventing any long-term effects from a stroke. If your headache symptoms change from your “usual” symptoms or you develop headache warning signs, you should also seek medical attention.

Sources:

Carolei A & Sacco S. Headache attributed to stroke, TIA, intracerebral haemorrhage or vascular malformation. Handb Clin Neurol. 2010;97:517-28.

Headache: Hope Through Research.” From the National Institute of Neurologic Disorders and Stroke website. Accessed 26 October 2009. http://www.ninds.nih.gov/disorders/headache/detail_headache.htm

Vestergaard K, Andersen G, Nielsen MI, & Jensen TS. Headache in stroke. Stroke. 1993 Nov;24(11):1621-4.

DISCLAIMER: The information in this site is for educational purposes only. It should not be used as a substitute for personal care by a licensed physician. Please see your doctor for diagnosis and treatment of any concerning symptoms or medical condition.

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