When we’re sick or feeling unwell, it’s not uncommon for a headache to be one of our symptoms. Headaches are also often listed as one of the most commonly reported side effects when taking a new medication or supplement. Most headaches are nothing to be concerned about, but are there times when they could be a sign of something more? We chatted with board-certified neurologist, Dr. Minsoo Kang to find out.

Recognizing Primary and Secondary Headaches

Headaches are classified in two categories: primary and secondary. A primary headache is one that occurs naturally, like a migraine, tension headache, or cluster headache. Secondary headaches are caused by an underlying disease or condition, such as a sinus infection, brain tumor, or head trauma like a concussion.

Dr. Minsoo Kang is a board-certified neurologist and is certified in Headache Medicine by the United Council for Neurologic Subspecialties.

Because strokes and migraines are both events in the brain, there is a strong overlap between the symptoms of stroke and those of migraine. Migraines usually develop at a younger age and rarely begin later in life, and they are often a recurrent event. Migraines often have triggers such as stress, weather changes, hormonal changes, lack of sleep, and sensory stimuli.

About 1/3 of migraine sufferers may experience a warning sign known as an aura before the headache comes on. This can involve flashes of light, blind spots or, less commonly, tingling on one side of the face, arm or leg, disorientation, and speech difficulties. This is always temporary but if it lasts more than 1 hour it may need to be investigated at once. It is particularly important to also be aware of risk factors that can further increase the inherent risk of stroke: having migraines with an aura (the risk is up to twice as high as it is in people who experience migraine without an aura), being younger than 45 years of age, smoking, taking medication that contains a high level of estrogen, and suffering from frequent migraines.

At Catholic Health, we will provide comprehensive care to treat any headache.”

Minsoo Kang, MD

Neurology, Mount St. Mary's Hospital

Don’t Ignore Secondary Headache Red Flags

If a headache is accompanied by other symptoms like numbness or vomiting, that is usually a sign that something else is going on. Thunderclap headaches are a great example of this – they are headaches that happen suddenly like a clap of thunder, and are often described as feeling like the worst headache of your life. Not all cases of thunderclap headaches are cause for concern, but they can be a sign of a life-threatening brain bleed or another underlying medical cause like meningitis or a hemorrhagic stroke.

In the event of a stroke-related headache, you may experience blurred vision, difficulty speaking, or dizziness. Like a thunderclap headache, patients with stroke-related headaches often describe them as feeling like the worst headache of their lives. Migraines and stroke headaches can have similar symptoms, but there are some key differences:

Migraine

  • Headache feels like intense pulsing or throbbing
  • Sensory sensitivity to lights, sounds, and movement
  • May feel skin tingling or see an aura
  • Migraines gradually gets worse

Stroke

  • Headache is sudden and without warning
  • Pain is severe or feels different from previous headaches
  • Accompanied by numbness, weakness, confusion, and loss of balance or vision

When to Seek Emergency Care

Brain damage from a stroke is permanent, which is why seeking immediate medical care is critical. If you see someone experiencing sudden and severe head pain, face drooping, slurred speech, or they can’t sit or stand upright, call 911 or get to the emergency room as quickly as possible.

At Catholic Health, we pride ourselves on being the regional hub for high-quality stroke care. A certified Comprehensive Stroke Center by the Joint Commission and recipient of the Advanced Certification for Comprehensive Stroke Centers, the nation’s highest and most demanding designation from the American Heart Association/American Stroke Association, our neurology team has the expertise to treat complex neurological cases.

Our specialists offer comprehensive neurological services, and use state-of-the-art equipment with the most advanced treatment options available. If you or a loved one experience frequent migraines, consider reaching out to our neurologists to evaluate your condition and review treatment options.