Dealing with a bad headache is annoying at baseline. But it can also send you into a spiral of health anxiety, wondering what could be causing your pain and when you should be concerned about a headache. After all, most people have heard that head pain can be a sign of something more serious, and that was recently underscored by two celebrities sharing their own scary experiences.
Wonder Woman star Gal Gadot recently opened up on The Tonight Show starring Jimmy Fallon about being diagnosed with blood clots in her brain while pregnant with her fourth child, something that she shared on Instagram in December. The 39-year-old said that she was eight months pregnant when she experienced an excruciating headache that lasted for three weeks. Doctors originally chalked her symptoms up to changing pregnancy hormones, but Gadot says her mom pushed for an MRI.
“They found out this horrible thing and we were rushed to the hospital,” she said. “And they got the baby out immediately.” After giving birth, Gadot went through a thrombectomy, which is a type of surgery to remove a blood clot. Despite the terrifying experience, Gadot is now healthy again.
Gadot’s interview comes just weeks after Real Housewives of Beverly Hills alum Teddi Mellencamp revealed that she had several tumors removed from her brain—and a headache was also her first symptom. “For the last several weeks I’ve been dealing with severe and debilitating headaches,” she shared in a February Instagram post. “Yesterday the pain was unbearable and required hospitalization. After a CT scan and MRI, doctors found multiple tumors on my brain, which they believe have been growing for at least six months.” Mellencamp revealed in a later update that she had four tumors surgically removed, and will undergo radiation therapy next.
It’s hard not to feel a little on edge after reading these stories, especially if you’re currently in the clutches of a monster headache. But while neurologists and emergency medicine physicians say that the majority of headaches don’t have a sinister cause, they also acknowledge that in rarer circumstances, they do. Here’s what they want you to know about headaches, plus when your symptoms may signal that something more serious could be going on.
There are two main categories of headaches: primary and secondary.
Headaches are usually divided into two major camps: primary headaches and secondary headaches. “Primary headaches most commonly include tension headache and migraine,” Amit Sachdev, MD, medical director in the Department of Neurology at Michigan State University, tells SELF. Primary just means the headache itself is the main issue, and there isn’t an underlying cause. “In primary headaches, the brain itself tends to be OK,” Dr. Sachdev says.
Tension headaches are the most common type, and can feel like a band is squeezing your forehead, with pain extending to your scalp and neck, per the US National Library of Medicine. Migraine symptoms can vary by person, but generally include moderate to severe throbbing pain that usually happens on one side of the head, along with nausea and sensitivity to light, according to the National Institute of Neurological Disorders and Stroke (NINDS).
When you hear about headaches caused by life-threatening medical conditions, those are secondary headaches, Walavan Sivakumar, MD, director of neurosurgery at Pacific Neuroscience Institute at Providence Little Company of Mary in Torrance, CA, tells SELF. “Secondary headaches have a clear reason why someone is in pain,” Dr. Sivakumar says. “These are the ones that scare people, like pain caused by brain tumors, blood clots, or bleeding in the head.”
Symptoms of primary and secondary headaches can overlap, but Dr. Sivakumar says there are a few telltale signs that you’re dealing with a secondary headache.
Signs your headache may be caused by a medical issue
Again, most headaches aren’t caused by something scary. But there are a few things doctors look out for that can signal a concerning cause behind your head pain. “The big things we’re worried about are bleeding in the brain, meningitis, and certain types of stroke,” Robert Shesser, MD, chair of the Department of Emergency Medicine at George Washington University, tells SELF.
For example, Gadot’s headaches were due to cerebral venous thrombosis (CVT), which is a very rare type of stroke caused by blood clots in the brain. Anyone can develop a blood clot, but women are especially vulnerable to experiencing them during pregnancy and in the postpartum period, according to the CDC. In fact, pregnant women are five times more likely to have a blood clot than those who aren’t expecting. Pregnancy-related clots most commonly occur in the legs and arms, known as deep vein thrombosis (DVT), or travel to the lungs, known as a pulmonary embolism (PE). Gadot’s experience with clots in her brain is extremely rare.
As Mellencamp’s story shows, headaches can also be due to a brain tumor, although this is also “very rare,” Whitney Luke, MD, pain medicine specialist, chair, and clinical professor of physical medicine and rehabilitation at The Ohio State University Wexner Medical Center, tells SELF.
Even still, there are plenty of less-concerning causes of headaches that are still worth getting checked out and treated for. These are the biggest signals you should see a medical professional about your head pain.
You have the worst headache of your life.
This tends to come on hard and fast, Erin Muckey, MD, associate professor of emergency medicine at Rutgers New Jersey Medical School, tells SELF. “The headache reaches peak intensity really quickly,” she says. If you’re experiencing this, Dr. Shesser says it’s important to head to the ER. “This is something you want to be seen quickly for,” Dr. Shesser says. It can suggest a few things, including a ruptured aneurysm, which is a weakened area of a blood vessel in or around your brain that bursts, he says. This is a life-threatening medical emergency.
The headache is different from your usual.
If you already experience headaches, you probably know what does and doesn’t feel normal to you. “A headache that’s new to you that persists is concerning,” Dr. Muckey says. “If you think, ‘This is new. My headaches usually go away when I get a good night’s sleep and that’s not helping,’ it’s worth getting checked out.”
You’re dealing with neurologic symptoms, too.
Having a headache is one thing, but adding other symptoms on top of that like new vision changes, numbness, tingling, weakness, or trouble speaking are a big concern, Dr. Sivakumar says. Among other things, these can be a sign of a stroke. “This is not something people should sit on,” he adds.
OTC medications aren’t helping.
To be fair, over-the-counter medications like acetaminophen (Tylenol) and ibuprofen (Advil or Motrin) don’t help to get rid of all primary headaches, including migraines. But if you usually find that they help with your headaches, but they’re not doing it this time around and your headache isn’t quitting despite trying to treat it, Dr. Sivakumar says it’s time to get an evaluation.
It’s persistent.
A headache that comes on and won’t stop isn’t just painful—it’s a sign that something else may be behind it, Dr. Muckey says. How long to give this depends on how you’re feeling. If things get progressively worse, she says you’ll want to be seen sooner rather than later. But if your headache comes on and is at a consistent but manageable level of discomfort, Dr. Shesser recommends getting it evaluated after a few days to a week (if you can stand it that long).
You have no clue what’s behind your pain.
If you’ve been grappling with work stress, haven’t been eating well, or have been exposed to your known migraine triggers, you probably have a solid idea what’s causing your headache. But if you’re clueless about what’s going on and you’ve tried home remedies like OTC medications and staying well hydrated, to no avail, Dr. Sivakumar recommends seeing a doctor.
Here’s what to expect when you get evaluated.
A healthcare provider should give you a physical exam, which includes looking at your eyes, taking your temperature, and learning more about your history with headaches, Dr. Sachdev says.
While it’s tempting to demand a CT scan or MRI right away to see what’s happening in your brain, doctors stress that isn’t necessarily the best route. “The majority of people don’t need imaging and we’re trying to balance the risk of giving someone unnecessary tests and radiation exposure with what imaging may show,” Dr. Muckey says. “The physician’s job is to determine whether or not this is concerning.” Unless they suspect you’re having a medical emergency, doctors will usually recommend tryinga different medication or lifestyle tweaks to see if they help clear up your headache first, Dr. Sachdev says.
But it’s OK to press for imaging under certain circumstances, Mark Conroy, MD, emergency medicine physician at The Ohio State University Wexner Medical Center, tells SELF. “Any time you have been seen more than once in an urgent care or emergency department location and no imaging has been completed but the symptoms have persisted, you should consider trying to see a neurologist or primary care provider in order to have imaging done,” he says.
Of course, if you have a headache and you’re uncomfortable, it’s something you should get checked out, regardless of whether you suspect it’s due to something more serious. But Dr. Muckey says there’s usually no need to panic if you develop a random headache. “Headaches are incredibly common,” she says. “The overwhelming majority of headaches will have no concerning causes.”
Related:
- 11 Reasons Why You Are Waking Up With a Headache
- How to Handle Unexpected Migraine Symptoms When They Strike
- Is Botox for Migraine Pain Worth It? We Asked 8 People for Their Honest Reviews
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