6 Head Pains You Should Never Ignore

By Bill Phillips and the Editors of Men's Health - Remember in the good old days, when doctors made house calls? Yeah, I don’t either. But it sounds awesome: No waiting rooms. No cranky receptionists. No parade of nurses, residents, and other strangers poking you. Just you and your doctor, in the privacy of your own home.

We have the next best thing here at Men’s Health: dozens of the nation’s top doctors on speed dial. Cardiologists, neurologists, dermatologists, dentists . . . you name it. They don’t make house calls, but they will talk to us from the privacy of our own phone.

One of our most prolific top docs is T.E. Holt, M.D., a physician at the University of North Carolina School of Medicine. We editors write from the patient’s perpective, but Dr. Holt writes from the doctor’s perspective. And he’s always insightful, whether he’s revealing keywords you can say to get a doctor’s attention or explaining how to spot a physician who doesn’t know what he’s doing.

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Recently, Dr. Holt wrote about one of the most common ailments in the world: the headache. If you're like most people, you've probably heard of the three major types of headaches:

1. Tension headache: This is your garden-variety headache, with diffuse pain wrapping across the top of your head. These headaches often result from stress or lack of sleep. They're not usually disabling, typically fade overnight, and can be easily relieved with ibuprofen, acetaminophen, or aspirin.

2. Migraine headache: Migraines tend to hit one side of the head, and can last from several hours to several days. They’re usually marked by a sensitivity to sound and light. When a migraine strikes, you can manage it with Advil Migraine or Motrin Migraine Pain (both ibuprofen medications) or Excedrin Migraine (a combination of aspirin, acetaminophen, and caffeine).

3. Cluster headache: This one is an excruciating attack that explodes behind one eye, reaches a crescendo after about an hour, and then vanishes—only to return in a day or so. This goes on for a few weeks, and then stops for months. Numerous drugs target clusters, including some of the migraine meds.

The good news about these headaches, says Dr. Holt, is that they're all completely harmless. But not every aching head is a simple headache. Here are six that could be a sign of something serious—and potentially deadly. Watch out for . . .

The Thunderclap Headache
If head pain hits you like a bolt out of nowhere, intensifying in a few minutes into the worst headache you've ever had, call 911. The list of causes for this kind of headache isn't long (aneurysm, stroke, meningitis) but almost everything on it can be very quickly fatal, says Dr. Holt.

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The Exercise Headache
If your headache comes on quickly and furiously with violent physical exertion, see a doctor right away. Chances are, the cause is benign, says Dr. Holt. But it also could be a subarachnoid hemorrhage.

The Headache that Spreads to Your Neck
Benign headaches stay in your head, says Dr. Holt. Headaches that don't can be meningitis or a hemorrhage. So yes, call 911, especially if you have a fever, are just getting over a bacterial infection, have a rash, or can't think clearly.

The Headache that Won't End
A headache that comes and goes for days—with a low-grade fever, visual disturbances, and aching in one or both of your temples—often signals an inflammation of the arteries that can leave you blind if not treated. See your doctor right away, says Dr. Holt.

The Contagious Headache
Your family is all home on a cold, rainy Saturday. As the day goes on you develop a headache that grows steadily worse. If anyone else has the same headache, move everyone outdoors immediately. There's a malfunction in your heating system and it's spewing carbon monoxide. Once you're out of the house, call the fire department. Your headache should clear up in a few hours.

The Headache that Wakes You Up
You should also be concerned if your headache has been worsening for weeks, says Dr. Holt, or if it’s present every morning when you wake up. This is the classic pattern for a slowly expanding mass. It may not warrant a 911 call, but you should see your doctor and schedule an MRI right away.

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