Headache is an extremely common symptom that can be caused by migraine, but also tumours, infections, and other illnesses There are more than 200 causes of headache in the International Classification of Headache Disorders.
The majority of headache arises from benign origins, such as migraine or tension-type headache. This means that the processes leading to the headache will not cause brain lesions or induce permanent damage. However, there are certain situations where headache should be investigated further.
Here is a list of situations and symptoms that warrant seeking medical advice:
- You have a history of cancer (even if treated or in remission): Cancer is associated with blood clots and brain metastasis.
- Your immune system is deficient: You take immunosuppressant medications or have a disease lowering your immunity.
- You have been losing weight, had a fever, or other unexplained signs of illness.
- You have any new neurological symptoms: This includes problems with vision, the ability to walk, coordination, speech, sensation, memory, and focus.
Note: If you are known to have typical auras, there is no need to worry every time you have one. But if you have new neurological symptoms, see a physician. - You experienced a headache that was sudden and severe: This is called “thunderclap” headache and should be investigated immediately. Go to the emergency room promptly, as it could indicate bleeding in the brain.
- You have headache that has been progressing over a few days or weeks with no explanation.
- You have new headache and are 50 years old or older: In this age bracket, the risk of having a headache that is not benign is higher.
- You have a headache different from your usual one: Even if you have migraine, you can still experience a different type of headache.
- Your headache is worse when lying down: The pressure in your head might be elevated.
- Your headache is worse when sitting or standing up: The pressure in your head might be too low.
- You are pregnant or have just given birth: Some serious health issues, like venous thrombosis and eclampsia, may occur during these times.
What if I have undergone tests, but no cause was found?
Remember that headache medicine is complex. Testing will exclude most causes of dangerous headache, but sometimes a clear diagnosis is not found. This is a stressful situation, but it does happen. In some cases, once the appropriate testing has been done, if the headache persists, it may be necessary to watch and wait.
My imaging is normal; do I only have migraine?
If your diagnosis is ultimately determined to be migraine and not a brain tumour, it is still important to receive appropriate treatment. Some physicians may dismiss migraine as a benign issue, but migraine can be highly disabling. There are many options available to improve your quality of life if you live with migraine.
My doctor did not prescribe any imaging. Should I be concerned?
If you do not exhibit any warning signs or red flags, your examination is normal, and your symptoms are consistent with typical migraine attacks, then imaging may not be necessary.
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