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Signs Your Migraine May be Something Serious

A headache specialist shares her warning signs.
FACT CHECKED BY Emilia Paluszek

As a headache specialist, it is extremely important to raise awareness of migraine as it is the second most disabling condition worldwide (in disability-adjusted life years). Over 40 million Americans (12% of the US population) have migraine. It is the most common cause of headaches when patients present for headache evaluation. (Tension type headache is the most common headache type but not the top reason for which patients present for care.) There are several warning signs or red flags for headaches. Read on to find out which could be serious—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


You Have Side-Locked Headache

woman with headache holds hand to her temple making a painful expression

One warning sign that a headache might be more serious than migraine is if the headache is side locked, meaning the side of the head on which the headache occurs does not change. This could be from an underlying issue like a tumor or aneurysm or something more life-threatening, so imaging may be warranted. 


You Experience a Sudden Onset

Mature woman standing home alone, worried, drinking coffee.

The second warning sign is sudden onset (as opposed to gradual onset). This could signify something more serious like an aneurysm rupture. 


You Have a New Type of Headache

Woman suffering from stress or a headache grimacing in pain as she holds the back of her neck with her other hand to her temple.

Another is a new type of headache after age 50, morning headaches, a history of cancer or HIV positivity, and changes in the neurologic exam.


You Experience These Abnormalities

Thoughtful girl sitting on sill embracing knees looking at window, sad depressed teenager spending time alone at home, young upset pensive woman feeling lonely or frustrated thinking about problems

If there are abnormalities on the neurologic exam e.g. a facial droop, seizure, change in mental status, weakness, or numbness on a side of the body, the patient should be investigated to ensure there is not something more concerning occurring.

A history of cancer, HIV positivity or immune suppression can also be concerning in the setting of new onset headache.


When You Should Go See the Doctor

doctor mature patient checkup

If the headache occurs with exercise, there should be further investigation. If the headache is 10/10, maximum in intensity within seconds, a person should seek emergency care.  Likewise, if there is a headache with an abnormality on exam like one of the ones mentioned above e.g. seizure, one should also seek emergency care. And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Dr. Mia Minen, MD, MPH is the chief of headache research at NYU Langone Health.

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