If the headache changes in intensity in different positions, like standing to lying, or is triggered by the Valsalva maneuver, such as coughing or straining, it can be concerning. These signs could point to a pressure issue or a problem related to some type of mass.
“Red flag signs and symptoms include focal neurologic signs, papilledema, neck stiffness, an immunocompromised state, sudden onset of the worst headache in the patient's life, personality changes, headache after trauma, and headache that is worse with exercise.”
Blue and red flag headaches are those in which some feature of the history or examination suggests that the headache is due to a secondary cause. Blue flag features (Table 3) indicate secondary headaches that do not require urgent investigation. Red flag features require urgent attention (Table 4).
Sometimes referred to as 'the five Cs', these are: chocolate, cheese, claret (and other red wines), coffee (and other sources of caffeine) and citrus fruits. While these foods are commonly held to be the main culprits in migraine, research suggests that the most common food trigger is actually wheat.
Simple pain relievers are the best medicine for minor headache relief. These medicines include acetaminophen, aspirin, ibuprofen, or naproxen.
Seek emergency care if:
The headache is accompanied by high fever, confusion, stiff neck, prolonged vomiting, slurred speech or numbness or weakness, especially on one side of the body. Headache medication does not relieve chronic or excruciating pain.
Cluster Headaches
These headaches are the most severe. You could have intense burning or piercing pain behind or around one eye. It can be throbbing or constant. The pain can be so bad that most people with cluster headaches can't sit still and will often pace during an attack.
How long is too long for a headache? Headaches usually go away within 4 hours, but it's not uncommon for the head pain to persist for longer. If your headache persists for longer than 72 hours, however, you should seek immediate medical attention.
In fact, a headache can be an early warning sign of more complicated and serious health issues such as stroke, infection, or high blood pressure.
People with brain tumors most often report that the headache feels like a tension headache. Some people say the headache feels like a migraine. Brain tumors in the back of the head might cause a headache with neck pain.
Patients with symptoms of cancer should be referred to secondary care as a 'red flag' referral. Red flag is the term used to indicate that this is a referral for a patient who is suspected of having cancer. Red flag referrals that are confirmed cancers should be treated within 62 days of the date of referral.
Red flags indicating a potential problem include: changes in eating habits, difficulty falling asleep or staying asleep, significant mood changes including depression, anxiety, panic or anger, demonstrating violent behaviors or utilizing alcohol, marijuana or prescription drugs to deal with stress.
Signs of High Blood Pressure
Severe headache. Difficulty breathing. Fatigue or confusion. Irregular heartbeat.
Definition. 'Red fiags' are alarm or warning symptoms, signs and near- patient diagnostic tests that suggest a potentially serious underlying disease. All red fiags can be regarded as 'diagnostic tests', in that their presence or absence adjusts the probability of a serious diagnosis.
Conditions that might cause nonprimary chronic daily headaches include: Inflammation or other problems with the blood vessels in and around the brain, including stroke. Infections, such as meningitis. Intracranial pressure that's either too high or too low.
The symptoms of a cluster headache include stabbing severe pain behind or above one eye or in the temple. Tearing of the eye, congestion in the associated nostril, and pupil changes and eyelid drooping may also occur.
Stress and muscle tension are often factors in these headaches. Tension headaches typically don't cause nausea, vomiting, or sensitivity to light. They do cause a steady ache, rather than a throbbing one, and tend to affect both sides of the head. Tension headaches may be chronic, occurring often, or every day.
Pain from a dehydration headache can range from mild to severe. You may feel pain all over your head or in just one spot, such as the back, front or side. The pain is usually like a dull ache, but it can also be sharp. You may have a throbbing (pounding) headache, or the pain might be constant.