Headaches: The Good, The Bad, and The Oh Crap!

Emergency Headaches

Two years ago I went to sleep perfectly happy and seemingly healthy, oblivious to what was about to happen. I fell right to sleep and then suddenly, at 2am, I woke out of bed feeling like I got stabbed in my head. Literally, my headache was so bad I felt like their was a knife in my brain! I knew instantly this was bad, “worst headache of my life” and “my headache woke me from sleep” are two phrases a doctor never wants to hear, it is inevitably bad! So being the doctor that I am, I dragged myself to the living room so I didn’t wake my husband, and performed all the physical exam tests for meningitis. Yeah, it was meningitis, I couldn’t move my neck to save my life at that point. It was pain that brought me to tears. Now the obvious thing to do was wake Marwan up and have him to take me to the ER, right? Eh, I figured why bother. I knew it was meningitis, I knew it was summer and it was most likely viral (viral meningitis is treated with NSAIDs and IV fluids), and I knew I was a young healthy adult that can fight off most illnesses. I kept my little illness to myself for about one day, not wanting to cause Marwan to worry. I just explained I had a bad headache. That jig lasted 24 hours and then the cyclic vomiting started for 14 hours, on the half hour. Oh joy. I really, really should have gone to the hospital, worst headache of my life plus vomiting generally means brain bleed or increased pressure in the brain, all bad stuff. I suffered it out for 3 weeks at home. Every night I cried trying to fall asleep but it hurt too bad to lay flat. When I did fall asleep, I woke up within two hours with that awful knife stabbing pain. I couldn’t eat more than soup broth without starting to throw up again. I eventually got better on my own, but I will forever have an unbelievable amount of empathy for my patients who have meningitis.

Why am I telling you this, June is Migraine Awareness Month and this week is National Headache Awareness Week, and while the majority of headaches are benign, there are some where you need immediate medical attention.

Emergency Headaches

When to See a Doctor for your Headache

  1. New headache or change in your normal headache: Generally not an emergency but you should schedule a doctor visit to make sure there isn’t a serious underlying reason.
  2. Worst headache of your life: This is usually emergent. Like I described above, any headache that brings you to tears and is the worst feeling of your life, deserves immediate medical attention.
  3. Accompanied by neurological changes: This is always emergent. Blurred vision, slurred speech, loss of function of arms, hands, or legs, numbness, droopy mouth, or droopy eye. This could be symptoms of a stroke and you should immediately call 911.
  4. Wake you from your sleep headache: Again, call your doctor because headaches waking you from sleep could signal a serious medical condition.
  5. New headache and recent unintentional weight loss: Call your doctor for an appointment. Unintentional weight loss always needs an evaluation, add in the new headache and there may be something serious going on.

Next week I will talk about those everyday headaches and how to treat them at home.

One Reply to “Headaches: The Good, The Bad, and The Oh Crap!”

  1. […] week we talked about the emergent types of headaches, but these are fairly uncommon and most of us hopefully won’t experience these in our life. […]

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