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When a Headache Is an Emergency

Posted 4/4/2016 by UHBlog

Learn when a serious headache requires immediate medical assistance. Ask us.

When a Headache is an Emergency

With the hustle and bustle of our busy lives, we all experience occasional headaches. Usually a couple of aspirins, a strong cup of coffee and a nap can bring relief. But when is a headache something more? When is it a critical warning sign?

“Although the vast majority of headaches – even agonizing headaches – don’t signal an emergency situation, headaches that cause sudden, explosive and unfamiliar pain or loss of consciousness, require immediate medical care,” says cerebrovascular neurosurgeon Nicholas Bambakidis, MD, Director, UH Neurological Institute. “This type of headache may signal a stroke, aneurysm or other neurovascular problem.”

So how do you know if you’re experiencing a potentially life-threatening headache? Symptoms associated with a headache that require immediate medical attention include:

  • Weakness, dizziness, sudden loss of balance or falling, fainting, numbness or tingling, paralysis, speech difficulties, mental confusion, seizures, personality changes and/or inappropriate behavior
  • Vision changes, such as blurry vision, double vision or blind spots
  • Pain that awakens you at night
  • Head pain after a head injury
  • Severe nausea and vomiting
  • Fever or stiff neck
  • An intense headache like nothing you’ve ever had before – even if you regularly get them

If you have a headache with any of these symptoms, call 9-1-1 or immediately go to an emergency room.

“The sooner someone seeks medical care, the better the outcome,” he says.

According to Dr. Bambakidis, one of the leading causes of red flag headache pain is a cerebral aneurysm. Just as a person may have no warning of an impending heart attack, there is almost no warning that a brain aneurysm is about to rupture.

“All cerebral aneurysms are different and can affect anyone at any point in their life, although they are most common in people 40 to 50 years old,” Dr. Bambakidis says. “They can run in families and can also be caused by a number of factors, including unchecked blood pressure, blood thinners, substance abuse or a strong blow to the head.”

An aneurysm is a weak or thin spot on a blood vessel in the brain that balloons out and fills with blood. The bulging aneurysm can put pressure on a nerve or surrounding brain tissue. It can also leak or rupture, spilling blood into the surrounding tissue, which can be fatal. Cerebral aneurysms can occur anywhere in the brain, but most are located along a loop of arteries that run between the underside of the brain and the base of the skull.

Because of medical advances in the neurosurgical/neurological and endovascular fields, treatment for brain aneurysms is more effective and less invasive than it was just five years ago when patients would have been told they had inoperable aneurysms.

“At our UH stroke and cardiovascular center, we perform about 120 brain aneurysm surgeries a year with a higher success rate than ever before,” Dr. Bambakidis says.

Surgeons often treat an aneurysm with the use of microsurgical tools and X-ray guidance.

“We carefully place soft platinum micro-coils into the aneurysm and then detach them,” he says. “The coils stay within the aneurysm and act as a mechanical barrier to blood flow, thus sealing it off. Our entire team of vascular surgeons and neuroradiologists work together for the safest and best outcome for the patient.”

Nicholas Bambakidis, MD, Director, UH Neurological Institute is a cerebrovascular neurosurgeon at University Hospitals Cleveland Medical Center and UH Ahuja Medical Center and the director, Cerebrovascular and Skull Base Surgery, and program director, Neurological Surgery, at University Hospitals Cleveland Medical Center. You can request an appointment with Dr. Bambakidis or any other University Hospitals doctor online.

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