When is a headache serious?

Headaches are an unfortunate fact of life, but most of the time, they’re nothing to worry about. They can certainly slow us down, but they’re usually easy to treat with a pain reliever and rest. However, there are some instances when a headache can indicate a serious problem that needs immediate medical attention. It’s important to understand how to know when a headache is an emergency so you don’t ignore a dangerous warning sign. 

Read on to learn about the different types of headaches, how to know when a headache is serious, and when you should go to the ER for a headache.

How to know when a headache is serious

If your headache is the worst you’ve ever had, comes on suddenly or explosively, or causes slurred speech or a change in vision, you should go to the emergency room right away. Dangerous headaches can be caused by serious problems like bleeding in or around the brain, a brain aneurysm or tumor, cancer, stroke, head injury, or a myriad of other health problems. 

When should you go to the ER for a headache?

These are the signs that you won’t want to ignore when having a bad headache. Serious headache symptoms include:

  • Sudden, severe headache that feels like a thunderclap
  • Fever and stiff neck
  • Weakness or numbness
  • Difficulty speaking
  • Fainting
  • Dizziness 
  • Seizures 
  • Double or blurred vision
  • Headache after head injury
  • Newly recurring headaches after age 50
  • Headache that gets steadily worse
  • Headache that worsens with coughing, exertion, straining, or sudden movement
  • Headache that accompanies stroke symptoms like facial drooping, arm weakness, and speech difficulty

If you experience any of the above symptoms, don’t neglect them. These serious headache symptoms signal an emergency and can indicate a dangerous health risk. 

young girl lying on couch with a bad headache holding hand to her forehead

Headaches in children: When to worry

Similar to adults, children of all ages — even infants — can experience headaches. An estimated 20% of teens get migraine headaches, which tend to start between the ages of 7 and 10. Though painful and uncomfortable, headaches don’t typically signal a serious underlying problem. They are most often caused by illness, stress, hormones, diet, dehydration, or a lack of sleep. 

But when is a child’s headache serious? There are times to worry about your children’s headaches, such as if they get headaches more than 15 days a month. This is an issue to bring up with their pediatrician. Similar to the serious headache symptoms listed above, a headache that wakes your child from sleep, isn’t improved by over-the-counter pain relievers, is joined by fever and stiff neck, or vomiting, are indications that your child’s headache is serious and warrants emergency treatment. 


If you or your child suffers from headaches, it’s helpful to be aware of the most common types of headaches, where they come from, and what they mean. The most common types of headaches are migraines and tension headaches. 

tension headache graphic

Tension headaches

A tension headache is the most common type of headache. Most people have experienced this kind of headache at some point in their life. A tension headache feels like dull pain on both sides of the head. It’s not usually a severe level of pain and is usually caused by stress and anxiety, dehydration, poor sleep, or eye strain. 

migraine headache graphic


Migraines are headaches with severe pain that disrupt normal activities. The pain is throbbing or pounding and can last for extended periods of time. Migraines can come with additional symptoms, like sensitivity to light and sound, an aura, and nausea or vomiting.

It’s not known why some people experience migraines and others don’t, but there is a genetic component, as they tend to run in families. According to Harvard Health Publishing, 70% of people with migraines have a close relative who also gets migraines. People with preexisting conditions like depression are also more prone to migraines. Migraine triggers — similarly to tension headache triggers — may include stress and anxiety, lack of sleep, dehydration, certain foods or missing a meal, and hormones.

cluster headache

Cluster headaches

Cluster headaches are less common than tension headaches and migraines, and they tend to be severe. Cluster headaches are recurring and can happen multiple times a day — usually half an hour to an hour at a time. Only 1 in 1,000 adults get cluster headaches, and men are six times more likely than women to suffer from them. The pain tends to be piercing behind one eye and can be accompanied by light and sound sensitivity, sweating, swollen eyelids or red/watering eyes, and restlessness. 

If you believe you’re suffering from cluster headaches, you should visit your doctor for imaging to make sure there’s not an underlying issue. Though extremely painful, cluster headaches on their own are not life-threatening. If this is your first time getting a cluster headache or your attack is severe, the emergency room can help manage pain and provide high-flow oxygen. 

thunderclap headache graphic

Thunderclap headaches

Thunderclap headaches are emergency headaches. They strike suddenly and tend to peak within a minute’s time and may be accompanied by nausea or vomiting. This type of headache may be caused by a ruptured blood vessel in the brain, blood clot in the brain, hypertensive crisis, bleeding in the brain, or other serious life-threatening emergencies. 

patient going to the ER for headache

Going to the ER for a Headache

If your pain is unmanageable, your headache matches some of the serious symptoms we’ve listed in this post, or your symptoms are worse than normal, go to the emergency room immediately. Here, you’ll be tested for serious medical conditions, and you’ll be treated for pain. 

When you need emergency room treatment for your headache in the Greater Houston area, don’t wait to visit your nearest Neighbors Emergency Center. Open 24/7/365, we’re here to make your life better. Each of our centers is equipped with state-of-the-art imaging equipment to evaluate your severe headaches.