According to Dr. Sheela Chakravarthy, Director – Internal Medicine, Fortis Hospitals, Bannerghatta Road, Bangalore, headache, whether mild or severe, should not be ignored. She believes it is not just a symptom, and says that the seriousness varies from person to person. “On a scale of 0 to 10, 7 represents a severe headache. If you have a severe headache interfering with your daily activities, you should seek medical attention. The majority of headaches are mild. Ten out of the hundred causes are serious, while the other 90 are self-limiting and do not require active intervention,” she explains.
Dr. Sowmya M, Consultant, Neurology, Aster RV Hospital shares, “Many people experience headaches on a regular basis. Sometimes they can have headaches which are not like their usual headaches. For instance, the character of their pain may be different, the severity or frequency may have increased, lasting for a longer duration.”
Signs your headache is concerning
According to Dr. Soumya M., warning signs of severe headache include sudden onset of headache, onset of headache after 50 yrs of age, increased frequency or severity of headache (change in pattern), new onset of headache with an underlying condition like HIV , Cancer. Positional headache, headache precipitated by sneezing, coughing or exercise, headache post-head injury or fall. New onset or severe headache during pregnancy or after delivery, headache with focal neurological signs like vision disturbance, weakness, numbness, loss of consciousness could also be concerning, she adds.
Dr. Chakravarthy says, “A person’s ability to predict when they will get a headache is known as an aura. Because it is a very general symptom, it necessitates a thorough understanding of how it began, how it progressed, and how many medications were administered.”
The following are examples of headaches that should not be ignored:
– Resulting in double vision
– Causes nausea
– Disrupts sleep and makes it difficult to carry out daily tasks
– Causes persistent vomiting
– Limb sluggishness
– Speech slurring
– Does not improve with time or painkillers
– Headache with systemic features like fever, weight loss
Possible causes of severe, persistent headache
When it comes to severe headaches, there is still no solid evidence to suggest why it happens. Your headache could be triggered by several factors.
According to Dr. Chakravarthy, in most cases, external factors result in headaches. “Anxiety, for example, can cause headaches, whereas migraines are more common in women. Typically, there are triggers such as hunger, tension, lack of or excessive sleep, bright lights, or nights, and so on, resulting in a pattern on one half of the head. In the case of migraines, a delay in medication may result in headaches that last for several days. There are numerous treatment options available,” she shares.
Additionally, cluster headaches could also be a common cause of severe headaches. It is mostly associated with symptoms such eye-watering and nasal congestion, which are frequently misdiagnosed as sinus headaches.
Another very uncommon but severe form of headache includes thunderclap headaches. It represents sudden, downright unbearable headaches that strike suddenly like a clap of thunder, wherein the pain peaks within 60 seconds. These appear out of nowhere after a workout or strenuous activity and cause unconsciousness.
Dr. Chakravarthy also discusses the link between headaches and a hypertensive crisis. “Most of the time, there is an associative blood pressure that has not manifested, and it is important to understand that headaches are not a manifestation of normal to high blood pressure but of excessively high blood pressure,” she says. Therefore, as a result, taking blood pressure at an earlier stage is a simple tool for identifying the problem and implementing effective corrective measures. It is most commonly associated with an artery with a weak wall that bursts into the brain, known as an aneurysm. According to the doctor, those at a risk of developing such illnesses should do regular evaluations, using tools like MRIs and MREs to assess the weaker arteries and avoid any fatal complications.
Furthermore, in the elderly, persistent headaches may be caused due to a fall or other subdural trauma, with some blood collected just outside the brain, known as post-traumatic headaches. These headaches can be treated and relieved if they appear early.
Other emergency causes of headache could be stroke – ischemic, hemorrhagic, brain tumours, brain infections- bacterial, viral, fungal, parasitic, tubercular, Cortical vein thrombosis, Idiopathic intracranial hypertension and glaucoma – increased eye pressure.
When to seek medical assistance?
If you develop frequent, severe headaches that last for more than 72 hours, Dr Soumya recommends seeking medical assistance. A new onset of headache with accompanying symptoms like fever, loss of consciousness, vision disturbances , fits, neurological defects, uncontrollable vomiting, then again you should consult your doctor immediately.
Dr Chakravarthy on the other hand recommends looking into the type of headache they’re experiencing, as the pattern of the headaches can reveal the severity of the problem.
Doctors warn against ignoring headaches that are persistent, long lasting and those that cause increasing pain. Early check-ups and treatments are critical to avoid or treat serious complications.