Thunderclap Headache = EmergencyA sudden, severe headache that reaches maximum intensity within 60 seconds ('worst headache of my life') may indicate subarachnoid haemorrhage. Call 999/911 immediately.
Headache Types at a Glance
| Type | Location | Duration | Key Features |
|---|---|---|---|
| Tension | Band around head | 30 min–7 days | Pressure, not throbbing; no nausea |
| Migraine | One side (usually) | 4–72 hours | Throbbing, nausea, light/sound sensitivity |
| Cluster | Around one eye | 15–180 min | Excruciating, occurs in clusters; eye watering |
| Medication overuse | Diffuse | Daily | From using painkillers >10–15 days/month |
| Thunderclap | Anywhere | Sudden peak | Worst ever — subarachnoid haemorrhage until proven otherwise |
| Raised ICP | Often worse lying | Persistent | Morning headache, vomiting, visual changes |
Migraine Red Flags vs Normal
- NEW severe headache in someone over 50 — see GP urgently
- Headache with fever, neck stiffness, rash — possible meningitis
- Headache following head injury
- Progressive worsening headache over weeks
- Headache with neurological symptoms (vision loss, weakness, speech problems)
Migraine DiaryKeep a headache diary for 3 months noting: date, duration, severity (1–10), triggers (food, sleep, hormones), and relief. This guides diagnosis and preventive treatment.
What's the difference between a migraine and a normal headache?
Migraines are typically one-sided, throbbing, moderate-severe intensity, with nausea and sensitivity to light/sound. They often last 4–72 hours. Tension headaches are bilateral pressure without nausea.
What triggers migraines?
Common triggers: skipped meals, dehydration, disrupted sleep, stress, bright lights, strong smells, hormonal changes (menstruation), alcohol (especially red wine), caffeine withdrawal.
When should I go to A&E for a headache?
Sudden severe onset (thunderclap), fever + neck stiffness, headache after head injury, neurological symptoms (weakness, vision loss, confusion), or if it's the worst headache of your life.
Can painkillers cause headaches?
Yes — medication overuse headache occurs when taking analgesics or triptans more than 10–15 days per month. Gradual withdrawal (under GP supervision) usually resolves it within weeks.
Medical Disclaimer: This page is for general education only and does not replace professional medical advice. Always consult a qualified healthcare provider.