Headaches are a common ailment that most of us experience from time to time.
But sometimes headaches can be a symptom of a more serious condition.
It’s important to know the “red flags” that can indicate when a headache requires medical attention.
In this article, we’ll go through ten key points for spotting red flags and dangerous headaches, as well as a useful mnemonic called SNARET.
This mnemonic stands for Symptoms, Neurological Signs, General Condition, Risk Factors, Elderly, and Previous Headaches, and can help you identify potentially serious headaches.
Remember, these are general guidelines and it’s important to seek medical help if you’re concerned about your headaches.
It’s always better to be safe than sorry.
1
Sudden and severe headache:
May indicate brain tumor, aneurysm or cerebral hemorrhage.
2
Headache with fever, stiff neck or confusion:
May indicate meningitis or other infection.
3
Headache that is aggravated by exertion, coughing or bending forward:
May be a sign of increased pressure in the head.
4
Persistent headaches that do not respond to painkillers:
May indicate an underlying chronic condition.
5
Changes in vision, speech or ability to move:
May be a sign of a neurological problem.
6
Sudden onset of “thunderclap” headache:
May be a sign of an aneurysm.
7
New or unusual neurological symptoms:
Weakness, numbness, visual changes may indicate secondary headaches.
8
Headache with fever, stiff neck, cramps, fainting or confusion:
May be a sign of a life-threatening condition.
9
Headache after head injury:
Requires immediate medical attention.
10
Headache with visual changes:
Could be a red flag.
Red flags for headaches:
The SNARET recall rule (from the Emergency Department Handbook)
S
Symptoms:
A sudden and severe headache can be a sign of a subarachnoid hemorrhage or an expansive process such as a tumor, hematoma, abscess, or cyst.
A headache that gradually gets worse can also be a sign of an expansive process.
A headache that gets worse with physical activity may be a sign of a condition that increases intracranial pressure, such as a tumor, sinus vein thrombosis, or idiopathic intracranial hypertension.
N
Neurological signs:
Paralysis, visual disturbances, speech difficulties, epileptic seizures, papilloedema can be signs of a number of conditions, including idiopathic intracranial hypertension, sinus vein thrombosis, infection, or a tumor.
A
General condition:
Fever, night sweats, weight loss, lethargy can be signs of meningitis, encephalitis, a tumor, metastases, or malignancy.
R
Risk factors:
Known cancer, HIV, pregnancy, obesity, hypertension, anticoagulation, familial glaucoma, drugs may be associated with a number of conditions including metastases, opportunistic infections, sinus vein thrombosis, carotid dissection, pituitary apoplexy, intracranial hemorrhage, malignant hypertension, glaucoma, and reversible cerebral vasoconstriction syndrome.
E
Older:
Older than 50 years at the onset of headache may be a red flag for temporal arteritis, malignancy, or malignant hypertension.
T
Previous headaches:
Previous headaches being completely different to the current one can be a red flag for many secondary headaches.
