Although a bad migraine might make you wish for the end of everything, headaches are not usually life threatening. However, a severe headache can signal something much more serious, requiring emergency attention such as stroke, aneurysm, and meningitis.
These are not terribly common, but it’s worth watching for a headache that feels markedly different from normal—even if normal is agonizing. Three signs to watch for:
1. A stiff neck and fever. This could be a sign of meningitis, an inflammation of the membranes surrounding the central nervous system, which can quickly become critical.
2. Severe nausea or vomiting and any neuro-deficit (such as difficulty speaking or walking), which could be signs of a hemorrhagic stroke.
3. A headache that’s far worse than anything you’ve ever had. “The thing we’re taught to look for is someone claiming to have ‘the worst headache of their life,'” says Adam Wilkes, MD, an ER specialist at Lankenau Hospital in Wynnewood, Pa. “It may mean that they have an aneurysm in the brain that has begun to leak a little blood, but could turn into a catastrophic full bleed. And that can be life threatening.”
If you go to the emergency room, expect the doctors to perform a CT scan, which can reveal a bigger problem. “We always like to be bothered,” says Dr. Wilkes. “Let me decide if there’s a problem or not. I’d so much rather have people come in unnecessarily and reassure them and send them home, than miss something that could have helped saved their life.”