When headaches signal trouble

Posted on 11 June 2013

Headaches affect 80% to 90% of people. Most headaches are merely an irritation and readily treated with a simple painkiller such as aspirin, but they can signal trouble. Dr Michael Gowen, neurosurgeon at Mediclinic Cape Town, talks about the warning signs.

I suffer from severe headaches. Is this something I should see my doctor about?
Ordinary headaches affect us all, with only 15% of us suffering headaches that are either severe enough or frequent enough to warrant seeing a doctor. Before puberty headaches are more common in boys and in adulthood headaches are four times more prevalent in women thanks so hormonal fluctuations. However, only one in 10 people might suffer a headache so traumatic it could signal something sinister.

How could I tell if a headache signals a dangerous underlying problem?
Generally even a severe headache is not a cause for alarm. However, if the cause of a headache is serious, other symptoms are often present such as vomiting, dizziness or confusion and disorientation.

There may be a serious reason behind it if you have a headache:
•    That is severe, comes on suddenly and gets steadily worse.
•    With a stiff neck – especially if accompanied by nausea, vomiting or fever.
•    For the first time ever
•    That is fundamentally different to normal
•    After physical exertion, such as exercise.
•    With drowsiness or confusion.
•    With physical symptoms such as abnormal speech, sensory loss which affects your sight, hearing or smell, tremors or muscular weakness and affecting the way you walk.
•    Within weeks of a head injury.

If you have any of the above symptoms with a severe headache see your doctor immediately, but always remember that while such symptoms could be a sign a serious condition, this is not always so. Don’t panic but don’t ignore it either.

How will my doctor diagnose my headache?
The cause of a headache is not always the easiest thing to diagnose, as a headache can be brought on by a staggering range of triggers which can include anything from stress or chocolate, to a life-threatening condition.

Headaches are essentially divided into primary headaches, which include your daily headaches such as tension headaches or migraines, and secondary headaches, which are brought on by a medical condition. This could be anything from toothache or sinus infection to meningitis, acute glaucoma, a stroke, brain tumour or concussion and other head trauma.

Because of this your doctor would do a thorough medical and neurological examination to look at possible causes for your headache.  If your headaches continue to get worse despite treatment, or if your doctor suspects an underlying cause such as a brain tumour or an aneurism, they may want to do an imaging test such as an MRA, MRI or CAT scan, but remember that these conditions are rare.

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The information provided in this article was correct at the time of publishing. At Mediclinic we endeavour to provide our patients and readers with accurate and reliable information, which is why we continually review and update our content. However, due to the dynamic nature of clinical information and medicine, some information may from time to time become outdated prior to revision.