No More Headaches: When Your Headache is an Emergency

Suzy Koelker had been in pain for two weeks before she got help for her headache. “I’d always had a lot of headaches,” the Dubuque, Iowa, woman recalls. “But this one was intense, like a pulsing pain across my temples.”

She tried over-the-counter painkillers with no relief. And no wonder: When she finally went to an urgent-care center, a CAT scan revealed swelling in her brain and an MRI showed a brain tumor pressing against the top of her skull.

Days later doctors removed a growth the size of a tennis ball. Fortunately, the tumor—a kind known as meningioma, which develops in the brain’s surrounding membrane—was benign, and Koelker, now 49, is pain-free and in good health. “I was lucky I got a doctor in urgent care who said we should check into this further and do a scan,” she says.

A severe headache should never be ignored, says Alan Carver, MD, assistant professor of neurology and director of headache and pain management at Mt. Sinai School of Medicine in New York City.

“It can be a warning sign of something more ominous: a brain tumor, stroke, or aneurysm.” Patients worry about stirring up drama for nothing, but it’s not worth taking chances. “You don’t have to apologize,” Carver says. “Headaches aren’t always just headaches.”

Call 911 if …

• You feel like it’s the worst headache you’ve ever had in your life.
• The headache is accompanied by a loss of vision, seeing double, weakness or numbness in your body, difficulty speaking or hearing, or trouble with balance or walking.
• You’re afraid you may pass out.

This article was first published in Health magazine, May 2009.

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