Are Headaches a Sign of Stroke?

Table of ContentsView AllTable of ContentsCausesWhat It Feels LikeStroke vs. MigraineAneurysm PainOther SymptomsGet Help Fast

Table of ContentsView All

View All

Table of Contents

Causes

What It Feels Like

Stroke vs. Migraine

Aneurysm Pain

Other Symptoms

Get Help Fast

Headaches in specific areas can sometimes signal a stroke. For example, a stroke in thecarotidartery, which supplies blood to the front of the brain, might cause pain in the forehead or face.Stroke-related headaches can also be more general, with mild to moderate pain, or they can be sudden and severe, like “thunderclap headaches,” which are common in hemorrhagic strokes (bleeding in the brain from a burst blood vessel).

In addition to headaches, strokes often cause other neurological symptoms, such as facial drooping, arm weakness, slurred speech, confusion, and trouble seeing.If you experience a sudden, severe headache along with any of these symptoms, it’s critical to seek emergency medical attention right away, as timely treatment can be lifesaving.

Do You Get Headaches Only During Slumber?.Hero Images/Getty Images

How Stroke Causes Headaches

Strokesare a medical emergency that happens when blood flow to the brain is interrupted. This is what causes headache. There are two types of strokes, both of which can cause this symptom:

Atransient ischemic attack(TIA)is a temporary interruption of blood flow in the brain that is sometimes called a “mini-stroke.” It comes on suddenly and gets better fairly quickly.(Most TIAs last around five minutes, but some can last for up to 24 hours.)

Despite the “mini-stroke” name, a TIA diagnosis is not based on the severity of symptoms, including headache. No matter how mild the symptoms are, a TIA should be treated just like a stroke and can be an early warning sign of a full stroke.

What Does a Stroke Headache Feel Like?

Both ischemic and hemorrhagic strokes cause headaches, but the headaches associated with them can vary in severity and location.

Hemorrhagic strokeis known for causing a “thunderclap headache.” People often describe this headache as the worst headache of their life. It hits hard and fast, reaching peak intensity within seconds to minutes. It usually affects the whole head.

Ischemic strokeheadaches often develop gradually and are more persistent. They tend to be less severe than thunderclap headaches, and are often described as being similar to a tension headache. Ischemic stroke headaches can affect one or both sides of the head.

There isn’t a specific headache location that means stroke. The location of the headache depends on the part of the brain affected. For example:

Headache can occur before, during, or after stroke symptoms start. According to one study, 86% of people reported a headache within the same day of stroke symptoms. The remainder of the individuals developed a headache two to five days later.

Stroke Headache vs. Migraine

As migraine headaches are also severe, you might wonder if you are experiencing one of them instead. There are some key differences between the two that are worth noting.

Stroke HeadachesPain may hit fast and peak within seconds to minutesPain tends to start without warningAccompanied with neurological symptoms, like confusion, weakness, and loss of balance

Pain may hit fast and peak within seconds to minutes

Pain tends to start without warning

Accompanied with neurological symptoms, like confusion, weakness, and loss of balance

Pain gradually increases in intensity

Sensory symptoms, like tingling skin and seeing flashes of light, often precede the pain

Rarely, amigrainous strokecan occur. In this case, a person experiences both amigraine with aura(head pain and sensory disturbances) and a stroke.

Could It Be an Aneurysm?

Ananeurysmis a bulge or weak area in the wall of a blood vessel in or around the brain. Not all aneurysms rupture. But when one does, it can cause bleeding in the brain, leading to hemorrhagic stroke.

A ruptured brain aneurysm typically triggers an intense thunderclap headache. There may also be other aneurysm-related headache symptoms, such as:

Many aneurysms start with small “microbleeds” before a more severe rupture occurs. These leaks often come with sudden headache pain, but the pain may not be as severe as a thunderclap headache.

Unruptured aneurysms may not cause any symptoms at first. However, a large unruptured aneurysm is known to cause:

Other Stroke Symptoms

The symptoms one experiences depend on the region of the brain affected. For example, strokes affecting thecerebrummay primarily impair speech abilities, while those affecting thecerebellumcan result in loss of coordination.

Importance of Immediate Stroke Treatment

If you have a severe headache that hits you suddenly and is unlike any pain you’ve had before, or you have other signs or symptoms of a stroke, do not delay in getting emergency medical attention.

A stroke can be fatal and every minute matters.Strokes damage the brain, and early diagnosis and treatment are key for preventing the long-term effects of the condition.

Even if you’re not having a stroke, a sudden, extremely painful headache can be a sign of other serious medical conditions (e.g.,bleedingorinfectionin the brain) that also need to be treated right away.

1:30Think FAST With a Stroke

1:30

Think FAST With a Stroke

Summary

There are two main types of stroke: ischemic stroke and hemorrhagic stroke. Ischemic strokes often cause headaches that have a tension-type quality affecting one or both sides of the head. Hemorrhagic strokes are known to cause thunderclap headaches, which hit fast and hard and usually affect the entire head. Both tend to occur without warning and happen along with other classic stroke symptoms, like weakness, numbness, dizziness, and slurred speech.

Strokes are a medical emergency. If you have any stroke symptoms, including a headache that is sudden and severe, call 911 or go to your nearest emergency room.

14 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hammond N, Ranta A.Yield of head computed tomography in patients with new onset of transient headaches.Intern Med J. 2017;47(10):1141-1146. doi:10.1111/imj.13517American Stroke Association.Stroke symptoms.Van Os HJA, Wermer MJH, Rosendaal FR, Govers-riemslag JW, Algra A, Siegerink BS.Intrinsic coagulation pathway, history of headache, and risk of ischemic stroke.Stroke. 2019;50(8):2181-2186. doi:10.1161/STROKEAHA.118.023124Edzie E, Dzefi-Tettey K, Gorleku P, et al.Evaluation of the anatomical locations of stroke events from computed tomography scan examinations in a tertiary facility in Ghana.Cureus. 2021 Mar;13(3):e14097. doi:10.7759/cureus.14097Johns Hopkins Medicine.Subarachnoid hemorrhage.American Stroke Association.TIA.National Health Service (UK).Transient ischemic attack (TIA).Nebraska Medicine.When is a headache a sign of a stroke or aneurysm?.de Oliveira F, Dourado-Filho M, Rocha-Filho P.Acute headache attributed to ischemic stroke: assessment of its characteristics and associated factors.Arq Neuropsiquiatr. 2023 Apr;81(3):225-232. doi:10.1055/s-0043-1763487Carvalho V, Cruz V.Clinical presentation of vertebrobasilar stroke.Porto Biomed J. 2020 Nov;5(6):e096. doi:10.1097/j.pbj.0000000000000096Harriott A, Karakaya F, Ayata C.Headache after ischemic stroke: a systematic review and meta-analysis.Neurology. 2020 Jan;94(1):75-86. doi:10.1212/WNL.0000000000008591Cedars-Sinai.Migrainous stroke.Centers for Disease Control and Prevention.Signs and symptoms of a stroke.Johns Hopkins Medicine.Effects of stroke.Additional ReadingAhmadi Aghangar A, Bazoyar B, Mortazavi R, Jalali M.Prevalence of headache at the initial stage of stroke and its relation with site of vascular involvement: A clinical study.Caspian J Intern Med. 2015;6(3):156-160.Pollak L, Shlomo N, Korn lubetzki I.Headache in stroke according to National Acute Stroke Israeli Survey.Acta Neurol Scand. 2017;135(4):469-475. doi:10.1111/ane.12621Tsai CL, Chou CH, Lee PJ, et al.The potential impact of primary headache disorders on stroke risk.J Headache Pain. 2016;17(1):108. doi:10.1186/s10194-016-0701-2

14 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Hammond N, Ranta A.Yield of head computed tomography in patients with new onset of transient headaches.Intern Med J. 2017;47(10):1141-1146. doi:10.1111/imj.13517American Stroke Association.Stroke symptoms.Van Os HJA, Wermer MJH, Rosendaal FR, Govers-riemslag JW, Algra A, Siegerink BS.Intrinsic coagulation pathway, history of headache, and risk of ischemic stroke.Stroke. 2019;50(8):2181-2186. doi:10.1161/STROKEAHA.118.023124Edzie E, Dzefi-Tettey K, Gorleku P, et al.Evaluation of the anatomical locations of stroke events from computed tomography scan examinations in a tertiary facility in Ghana.Cureus. 2021 Mar;13(3):e14097. doi:10.7759/cureus.14097Johns Hopkins Medicine.Subarachnoid hemorrhage.American Stroke Association.TIA.National Health Service (UK).Transient ischemic attack (TIA).Nebraska Medicine.When is a headache a sign of a stroke or aneurysm?.de Oliveira F, Dourado-Filho M, Rocha-Filho P.Acute headache attributed to ischemic stroke: assessment of its characteristics and associated factors.Arq Neuropsiquiatr. 2023 Apr;81(3):225-232. doi:10.1055/s-0043-1763487Carvalho V, Cruz V.Clinical presentation of vertebrobasilar stroke.Porto Biomed J. 2020 Nov;5(6):e096. doi:10.1097/j.pbj.0000000000000096Harriott A, Karakaya F, Ayata C.Headache after ischemic stroke: a systematic review and meta-analysis.Neurology. 2020 Jan;94(1):75-86. doi:10.1212/WNL.0000000000008591Cedars-Sinai.Migrainous stroke.Centers for Disease Control and Prevention.Signs and symptoms of a stroke.Johns Hopkins Medicine.Effects of stroke.Additional ReadingAhmadi Aghangar A, Bazoyar B, Mortazavi R, Jalali M.Prevalence of headache at the initial stage of stroke and its relation with site of vascular involvement: A clinical study.Caspian J Intern Med. 2015;6(3):156-160.Pollak L, Shlomo N, Korn lubetzki I.Headache in stroke according to National Acute Stroke Israeli Survey.Acta Neurol Scand. 2017;135(4):469-475. doi:10.1111/ane.12621Tsai CL, Chou CH, Lee PJ, et al.The potential impact of primary headache disorders on stroke risk.J Headache Pain. 2016;17(1):108. doi:10.1186/s10194-016-0701-2

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Hammond N, Ranta A.Yield of head computed tomography in patients with new onset of transient headaches.Intern Med J. 2017;47(10):1141-1146. doi:10.1111/imj.13517American Stroke Association.Stroke symptoms.Van Os HJA, Wermer MJH, Rosendaal FR, Govers-riemslag JW, Algra A, Siegerink BS.Intrinsic coagulation pathway, history of headache, and risk of ischemic stroke.Stroke. 2019;50(8):2181-2186. doi:10.1161/STROKEAHA.118.023124Edzie E, Dzefi-Tettey K, Gorleku P, et al.Evaluation of the anatomical locations of stroke events from computed tomography scan examinations in a tertiary facility in Ghana.Cureus. 2021 Mar;13(3):e14097. doi:10.7759/cureus.14097Johns Hopkins Medicine.Subarachnoid hemorrhage.American Stroke Association.TIA.National Health Service (UK).Transient ischemic attack (TIA).Nebraska Medicine.When is a headache a sign of a stroke or aneurysm?.de Oliveira F, Dourado-Filho M, Rocha-Filho P.Acute headache attributed to ischemic stroke: assessment of its characteristics and associated factors.Arq Neuropsiquiatr. 2023 Apr;81(3):225-232. doi:10.1055/s-0043-1763487Carvalho V, Cruz V.Clinical presentation of vertebrobasilar stroke.Porto Biomed J. 2020 Nov;5(6):e096. doi:10.1097/j.pbj.0000000000000096Harriott A, Karakaya F, Ayata C.Headache after ischemic stroke: a systematic review and meta-analysis.Neurology. 2020 Jan;94(1):75-86. doi:10.1212/WNL.0000000000008591Cedars-Sinai.Migrainous stroke.Centers for Disease Control and Prevention.Signs and symptoms of a stroke.Johns Hopkins Medicine.Effects of stroke.

Hammond N, Ranta A.Yield of head computed tomography in patients with new onset of transient headaches.Intern Med J. 2017;47(10):1141-1146. doi:10.1111/imj.13517

American Stroke Association.Stroke symptoms.

Van Os HJA, Wermer MJH, Rosendaal FR, Govers-riemslag JW, Algra A, Siegerink BS.Intrinsic coagulation pathway, history of headache, and risk of ischemic stroke.Stroke. 2019;50(8):2181-2186. doi:10.1161/STROKEAHA.118.023124

Edzie E, Dzefi-Tettey K, Gorleku P, et al.Evaluation of the anatomical locations of stroke events from computed tomography scan examinations in a tertiary facility in Ghana.Cureus. 2021 Mar;13(3):e14097. doi:10.7759/cureus.14097

Johns Hopkins Medicine.Subarachnoid hemorrhage.

American Stroke Association.TIA.

National Health Service (UK).Transient ischemic attack (TIA).

Nebraska Medicine.When is a headache a sign of a stroke or aneurysm?.

de Oliveira F, Dourado-Filho M, Rocha-Filho P.Acute headache attributed to ischemic stroke: assessment of its characteristics and associated factors.Arq Neuropsiquiatr. 2023 Apr;81(3):225-232. doi:10.1055/s-0043-1763487

Carvalho V, Cruz V.Clinical presentation of vertebrobasilar stroke.Porto Biomed J. 2020 Nov;5(6):e096. doi:10.1097/j.pbj.0000000000000096

Harriott A, Karakaya F, Ayata C.Headache after ischemic stroke: a systematic review and meta-analysis.Neurology. 2020 Jan;94(1):75-86. doi:10.1212/WNL.0000000000008591

Cedars-Sinai.Migrainous stroke.

Centers for Disease Control and Prevention.Signs and symptoms of a stroke.

Johns Hopkins Medicine.Effects of stroke.

Ahmadi Aghangar A, Bazoyar B, Mortazavi R, Jalali M.Prevalence of headache at the initial stage of stroke and its relation with site of vascular involvement: A clinical study.Caspian J Intern Med. 2015;6(3):156-160.Pollak L, Shlomo N, Korn lubetzki I.Headache in stroke according to National Acute Stroke Israeli Survey.Acta Neurol Scand. 2017;135(4):469-475. doi:10.1111/ane.12621Tsai CL, Chou CH, Lee PJ, et al.The potential impact of primary headache disorders on stroke risk.J Headache Pain. 2016;17(1):108. doi:10.1186/s10194-016-0701-2

Ahmadi Aghangar A, Bazoyar B, Mortazavi R, Jalali M.Prevalence of headache at the initial stage of stroke and its relation with site of vascular involvement: A clinical study.Caspian J Intern Med. 2015;6(3):156-160.

Pollak L, Shlomo N, Korn lubetzki I.Headache in stroke according to National Acute Stroke Israeli Survey.Acta Neurol Scand. 2017;135(4):469-475. doi:10.1111/ane.12621

Tsai CL, Chou CH, Lee PJ, et al.The potential impact of primary headache disorders on stroke risk.J Headache Pain. 2016;17(1):108. doi:10.1186/s10194-016-0701-2

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