5 Headache Warning Signs

Woman holding her head in pain
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Most times, headaches are simply a nuisance. But sometimes they are indicative of something more serious.

Watch out for these 5 headache warning signs and seek medical attention if they occur.

Thunderclap Headache

 If you experience an abrupt, severe headache "like a clap of thunder," do not hesitate, call 911 or go to your nearest emergency room. The biggest concern for a thunderclap headache is a subarachnoid hemorrhage, which indicates there is bleeding in your brain.

Classically, the headache of SAH is sudden, explosive, one-sided and associated with nausea, vomiting, mental status changes, and neck stiffness.

Of course, there are medical conditions that mimic a thunderclap headache. But only a healthcare provider can make this determination after evaluating you and ordering necessary brain imaging. Regardless, a thunderclap headache can represent a serious, life-threatening medical condition, so get help right away.

Headache with Vision Changes or Other Neurological Symptoms

If you suffer from migraines with aura, you are probably familiar with the classic vision changes of an aura—an arc of flashing lights that marches across your field of vision and lasts for over 5 minutes and less then 60 minutes. You may also note sparkles, squiggles, TV static, and halos.

But if your vision changes are different than your typical auras, or you are experiencing new head pain and/or new vision changes or eye pain, seek medical attention immediately.

Head pain and eye pain could indicate something more than a migraine, like optic neuritis or herpes zoster opthalmicus (especially if there is also a rash).

A headache and new vision changes (for example, sudden vision loss) could be a signal of a stroke, brain tumor, infection in the brain, or giant cell arteritis (especially if you are over the age of 50).

Likewise, a headache and neurological signs like numbness, tingling, and/or weakness are also indications to call 911. These could be signs of a stroke.

Change in Headache Pattern

If your headache feels different from your usual headaches, is more severe, or is occurring more frequently, seek medical attention. This may be the only signal that something else is going on.

New Headache

If you start getting headaches when you did not before, even if they are mild, get it checked out. This is especially true if you are over the age of 50.

Headache and Systemic Symptoms

Systemic symptoms are whole-body symptoms like fever, weight loss, night sweats, or generalized fatigue or malaise. There are a number of medical conditions that may cause headache and systemic symptoms. Some are more serious than others, like meningitis or HIV or AIDS.

Other conditions that may cause headache and systemic symptoms (other then infections) include: autoimmune diseases like: systemic lupus erythematosus(SLE), sarcoidosis, and giant cell arteritis. There are also rarer causes of headache and fever such as: subarachnoid hemorrhage, pituitary apoplexy, or a brain tumor.

See a healthcare provider if you have systemic symptoms in addition to your headache.

A Word from Verywell

It's better to err on the side of caution. Listen to your gut instinct. If you suffer from any of the above symptoms, seek appropriate medical guidance.


American Headache Society. Primary or Secondary Headaches?

Bahwa ZH & Wooton RJ. Evaluation of headache in adults. In: UpToDate, Basow DS (ed), UpToDate, Waltham, MA, 2013.

Buchholz, David & Reich, Stephen G (foreword). Heal Your Headache: The 1-2-3 Program For Taking Charge of Your Pain. New York: Workman, 2002.

Hainer BL, Matheson EM. Approach to acute headache in adults. Am Fam Physician. 2013 May 15;87(1):682-87.

Headache Classification Committee of the International Headache Society. "The International Classification of Headache Disorders: 3rd Edition (beta version)". Cephalalgia 2013;33(9):629-808.

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