A stroke occurs when blood flow to a part of the brain is interrupted, a medical emergency that deprives brain cells of the oxygen and nutrients they need. Brain cells can begin to die within minutes without this essential supply, potentially leading to lasting damage or disability. While a headache can be a symptom of a stroke, it is often not the only or most prominent sign. Recognizing all potential symptoms is important for timely medical intervention.
Characteristics of a Stroke Headache
A headache associated with a stroke has a sudden onset. Many describe it as the “worst headache of my life,” often called a thunderclap headache, reaching peak intensity within seconds to minutes. This severe pain can be accompanied by nausea or vomiting. Not all strokes cause headaches, and not all severe headaches indicate a stroke. Headaches of this intensity are more commonly linked with hemorrhagic strokes, which involve bleeding in the brain.
Where Stroke Headaches Occur
The location of a stroke headache can vary and is not always a definitive indicator. In hemorrhagic strokes, involving bleeding, the headache might be localized to the bleed area or be a generalized, severe pain across the head. For ischemic strokes, caused by a blood clot, headaches are less frequent and tend to be less specific in location or may be absent. These headaches might feel like a tension-type headache, often affecting both sides of the head or primarily the front. The location of a headache alone is not sufficient for diagnosing a stroke.
Other Signs of Stroke
A headache, if present during a stroke, is almost always accompanied by other neurological symptoms that are more definitive indicators. Healthcare professionals use the F.A.S.T. acronym to identify these signs quickly.
Face drooping: One side of the face may appear uneven or droop when smiling.
Arm weakness: One arm drifts downward when the person attempts to raise both arms.
Speech difficulty: Speech may be slurred, or the person may have trouble understanding.
Time: Call emergency services immediately if any of these signs are observed.
Other sudden symptoms that can indicate a stroke include confusion, trouble seeing in one or both eyes, or sudden difficulty walking. Dizziness, loss of balance, or problems with coordination can also be signs. Sudden numbness or weakness on one side of the body, affecting the face, arm, or leg, is another common symptom that warrants immediate attention.
What to Do in a Stroke Emergency
A stroke is a medical emergency requiring immediate action. If you suspect someone is having a stroke, call emergency services, such as 911 in the U.S., without delay. This immediate response is important because “time is brain,” meaning prompt medical attention can improve outcomes. For every minute that passes during a stroke, an estimated 1.9 million brain cells can be lost.
Do not attempt to drive the person to the hospital yourself. Paramedics are equipped to begin life-saving treatment en route to the emergency room. When speaking with emergency responders, note the exact time symptoms first appeared, as this information guides treatment decisions.