Most patients presenting with headache are managed medically with excellent response to treatment. There are various over the counter and prescription based medication available both for treating acute episodes of headache as well as to prevent episodes of severe headache.
Overview of Headaches
Headaches are a common and unpleasant type of pain that affects the head, neck, and face. They range from mild to severe and can present themselves differently based on the root cause and the individual. Headaches are a complex and nuanced condition to manage that may require treatment from a headache specialist in Singapore.
There are two types of headaches: primary and secondary. Many of us are familiar with primary headaches which don't have a specific underlying cause. These include migraine, cluster, and tension headaches. Secondary headaches are a response to issues such as infection, injury, or other underlying medical conditions. Identifying and addressing the root cause of head pain is essential in managing secondary headache symptoms.
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Common Questions About Secondary Headaches
What is a secondary headache?
A secondary headache is a headache caused by another underlying medical condition rather than being a headache disorder on its own.
Unlike primary headaches, such as migraine or tension headaches, secondary headaches occur because another issue is affecting the brain, blood vessels, nerves or surrounding structures.
Possible causes include:
- Brain aneurysms
- Bleeding around the brain
- Stroke
- Head injuries
- Infections
- Blood vessel abnormalities
- Increased pressure inside the skull
- Certain medications or medical conditions
Identifying the cause is important because some secondary headaches may require urgent medical attention.
What is the difference between a primary headache and a secondary headache?
The key difference is whether there is an underlying cause.
| Type of Headache | Description |
|---|---|
| Primary headache | Headache occurs as the main condition, such as migraine or tension headache |
| Secondary headache | Headache occurs because of another medical problem |
Primary headaches are common and often managed through lifestyle changes and medication.
Secondary headaches require assessment to determine and treat the underlying cause.
What causes secondary headaches?
Secondary headaches can develop due to many different conditions.
Possible causes include:
Brain aneurysm
A brain aneurysm is a weakened area in a blood vessel that can enlarge or rupture. A sudden severe headache may occur when an aneurysm bleeds.
Stroke
Changes in blood flow to the brain, including bleeding or blockage of blood vessels, may cause headaches alongside other neurological symptoms.
Blood vessel abnormalities
Conditions affecting brain blood vessels may contribute to headaches.
Head injury
Trauma can cause headaches through bleeding, inflammation or changes within the brain.
Increased pressure inside the skull
Conditions that increase pressure around the brain may cause persistent or worsening headaches.
What headache symptoms require urgent medical attention?
Some headaches require urgent assessment, especially when symptoms are sudden, severe or different from previous headaches.
Seek emergency medical attention if you experience:
- A sudden severe headache that reaches maximum intensity quickly
- A “worst headache of your life”
- Headache with loss of consciousness
- New weakness or numbness on one side of the body
- Difficulty speaking
- Sudden vision changes
- Seizures
- Confusion
- Fever with neck stiffness
- A new headache pattern that is unusual for you
These symptoms may indicate serious conditions requiring immediate evaluation.
Can a brain aneurysm cause headaches?
Yes, a brain aneurysm can sometimes be associated with headaches.
An unruptured brain aneurysm may not cause symptoms and is often discovered during imaging performed for another reason.
When an aneurysm ruptures, it can cause bleeding around the brain and may present with:
- Sudden severe headache
- Nausea or vomiting
- Neck stiffness
- Loss of consciousness
- Neurological symptoms
A sudden severe headache should always be assessed urgently.
Understanding Secondary (Organic) Headaches
Unlike primary headaches, secondary headaches are not a standalone condition but a symptom of other possible health issues. Primary headaches, such as migraine, occur independently and are not necessarily triggered by something else that is going on in the body. Secondary headaches are usually triggered by conditions that affect surrounding muscles, blood vessels, or nerves. They display several warning signs and symptoms, which we will dive into shortly.
Symptoms and Warning Signs of Secondary Headaches
At the end of the day, you know your body best. If something seems off and you are experiencing sudden and spontaneous headaches, it's important to seek the opinion of a medical professional. Below are possible symptoms of warning signs, but they are not full-scale.
- A headache that is accompanied by other symptoms, such as a fever, confusion, or vision changes. Depending on the severity, these could indicate an infection or neurological disorder.
- A headache that occurs in individuals who have recently experienced a head injury or have a medical history of cancer, preeclampsia, or metastatic tumor.
- A headache that is unresponsive to treatments. This could indicate a hormonal imbalance or a chronic condition such as diabetes. It could also indicate a medication headache overuse, meaning, the medication ends up "rebounding" and causing more headaches.
- Other signs include sudden headaches that bring a different sensation than usual, especially to those over the age of 50; headaches that wake you up from sleep; headaches that worsen when moving around or coughing and sneezing, etc.
Underlying Conditions of Secondary Headaches
As mentioned above, a patient's underlying health is what triggers secondary headaches. Root causes such as trauma from an injury are easy to ascertain while other conditions such as infection can be more complicated to diagnose. If you are experiencing sudden headaches accompanied by the above symptoms, you should be evaluated by a headache specialist in Singapore. Underlying conditions include but are not limited to the following:
- A brain tumor is an abnormal growth of cells in the brain. They can be noncancerous or cancerous and cause headaches, vomiting, vision changes, and more due to the mass's pressure on the brain tissue.
- High blood pressure is a condition where blood is circulating too fast, putting stress on the arteries, heart, and blood vessels. This includes the neck and head area and may even cause dizziness and chest pains.
- Infections that stem from bacteria or viruses cause inflammation of the tissue in your body. These infections can spread to and affect the brain and membranes along the spinal cord.
- Spontaneous Intracranial Hypotension (SIH) is a condition that stems from low fluid pressure in the skull. In essence, the dura (a membrane that covers the spinal cord and brain) leaks spinal fluid, causing intracranial hypotension.
- Other Head Diseases and Disorders such as arterial tears, blood clots, and acute sinusitis (inflammation of the sinuses) can cause secondary headaches.
Healthy Lifestyle Strategies to Avoid Secondary Headaches
For root causes such as high blood pressure, your doctor may recommend exercise, eating healthy, and taking certain medications. Other causes such as sinusitis will require you to avoid allergens, smoke, and other weather-related triggers. For optimal health in general, it's extremely beneficial to remain active, stay hydrated, get enough sleep, and reduce stress.
Neurointerventional Procedures
Neurointerventional procedures are minimally invasive treatments for secondary headaches. They are performed by specialists and target the blood vessels and nerves in the head, neck, and face area.
- Embolization is a procedure that blocks blood flow to certain vessels which reduces the pressure that causes headaches.
- Nerve stimulation uses electrical impulses to stimulate and regulate nerves that carry pain signals to the brain.
- Angioplasty and stenting use a small medical balloon to inflate an artery and then insert a mesh tube (stent) to keep it open which improves blood supply to the brain.
When to Consider a Specialist Assessment for Secondary Headaches in Singapore
Most headaches are not caused by serious conditions. However, certain headache patterns require further evaluation to understand whether there is an underlying neurological or vascular cause.
Consider arranging a specialist assessment if you:
- Experience a sudden severe headache that is different from previous headaches.
- Develop a new headache pattern later in life.
- Have headaches associated with weakness, numbness, speech difficulty or vision changes.
- Have been diagnosed with a brain aneurysm or vascular abnormality.
- Have persistent headaches that are worsening over time.
- Have headaches after a head injury.
- Want a second opinion about imaging findings or your diagnosis.
- Are concerned about whether your headaches may be related to blood vessel problems.
At the Supreme Vascular and Interventional Clinic, assessment focuses on understanding whether headaches may be related to underlying neurovascular conditions. Your specialist will review your symptoms, medical history and relevant brain or blood vessel imaging to determine the most appropriate next steps.
The goal is to help patients understand the cause of their symptoms, identify potential risks early and receive personalised care when further evaluation or treatment is needed.
Seek emergency medical attention immediately if you experience a sudden severe headache, loss of consciousness, new neurological symptoms or signs of stroke.
Consult With Supreme Vascular and Interventional Clinic Today
If persistent or severe headaches disrupt your daily life, it's time to consult with a headache specialist in Singapore. Dr. Manish Taneja has nearly 30 years of experience and a dually trained and certified neuro interventional and peripheral vascular interventionist in Singapore. Contact our clinic today for compassionate and professional care.
Read More About Neurointerventional Treatments on Our Blog
To dive deeper into the types of neurointerventional treatments, head over to our clinic’s blog.
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- Brain Aneurysm Q&A with Dr. Manish Taneja
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Neurointerventional / Stroke Treatments
The Supreme Vascular and Interventional Clinic is your "go-to" facility for various neurointerventional / stroke conditions and treatments. To arrange an appointment with Dr. Manish Taneja, our neurointervention specialist, contact us. You can also call us at (+65) 6904 8084 for a consultation.