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Reviewed by the Faculty of Harvard Medical School

"Red Flags"

Many people worry that their headaches are caused by a serious medical problem, such as a brain tumor, aneurysm, stroke or infection. In fact, it is quite rare for this to be the case. Although headaches may be a symptom when something goes wrong with the brain, it is very uncommon for headaches to be the only symptom. Health care professionals usually worry about a patient's headaches only when certain "red flags" (warning signs) are present, such as:

  • Headaches that are getting worse over time
  • New headaches in a person older than 40
  • The "worst headache of my life"
  • Severe headaches that start suddenly (often known as "thunderclap" headaches)
  • Headaches that worsen with exercise, sexual intercourse, coughing or sneezing
  • Headaches with unusual symptoms, such as passing out, loss of vision or difficulty walking or speaking
  • Headaches associated with fever (higher than 100 F), stiff neck or rash
  • Headaches that start after a head injury
  • Headaches that always occur on the same side of the head
  • Headaches in a person with certain medical problems, including high blood pressure, cancer or AIDS
  • Headaches in a person with a family history of brain aneurysms
  • Abnormal findings on neurological exam, such as abnormal eye movements, difficulty walking or weakness in an arm or leg

It is important to keep in mind that, even when these red flag symptoms are present, most people do not have a serious underlying cause for their headaches. However, your health care professional may rely on these symptoms to decide whether further evaluation — such as a computed tomography (CT) or magnetic resonance imaging (MRI) scan — is necessary.

Last updated June 5, 2008




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