Headache is one of the most common complaints, and most are tension-type or migraine, managed at home and in clinic. Your job isn't to diagnose yourself — it's to know the red flags that move a headache from the clinic to the ER.
In short — what to do
- Sudden and the worst of your life — peaking within seconds to a minute (a thunderclap).
- With fever and a stiff neck, or a rash.
- With one-sided weakness or numbness, slurred speech, visual disturbance, or confusion.
- After a blow to the head — especially with vomiting or unusual drowsiness.
- New and progressive after age 50, or with repeated morning vomiting.
- In late pregnancy, or in a patient with cancer, weak immunity, or blood thinners.
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The full details
Go to the ER immediately if the headache is
- Sudden and the worst of your life — peaking within seconds to a minute (a thunderclap).
- With fever and a stiff neck, or a rash.
- With one-sided weakness or numbness, slurred speech, visual disturbance, or confusion.
- After a blow to the head — especially with vomiting or unusual drowsiness.
- New and progressive after age 50, or with repeated morning vomiting.
- In late pregnancy, or in a patient with cancer, weak immunity, or blood thinners.
The usual headache: what helps
- Enough water, regular sleep, fewer screens during an attack.
- A simple painkiller (paracetamol) at the right dose — and avoid overuse: daily repeated painkillers cause "medication-overuse headache".
- Note when it comes and what precedes it — a headache diary shortens your doctor's path.
A simple rule
A headache that resembles your usual one usually behaves like it. The "first of its kind" or "worst of your life" headache is the one that deserves the ER.
This content is for general health education only and is not medical advice. Always seek guidance from a qualified healthcare professional. In an emergency, call 998.