6. Your headache started after you hit your head. Even if it was a moderate bump and you didn't black out, you should get to the ER because your head pain may stem from a concussion. Although most such injuries are not serious, concussions with bruising or bleeding on the brain can lead to vision loss, balancing problems, confusion and even death.
7. Your head pain comes on repeatedly, in severe, sudden flashes, when you cough, sneeze, bend down, or strain during a bowel movement or sex. This may be a sign of a worrisome condition such as vascular disease of the head or neck, an aneurysm or tumor, or other structural problems in the brain.
8. You have cancer or HIV/AIDS and develop a new headache. Any new headache in a patient with HIV/AIDS could mean a brain infection such as meningitis, which should be evaluated promptly by a doctor. A new headache in a cancer patient doesn't necessarily demand a trip to the ER but should be seen promptly by the patient's own doctor. Shingles (herpes zoster) around the eye or forehead can cause permanent damage to eye and vision loss.
9. You have a severe headache plus pain and tenderness on your scalp, temples and jaw. This could a sign of temporal arteritis, an inflammation of the arteries that occurs almost exclusively in older adults. Believed to be an autoimmune condition, temporal arteritis must be treated as soon as possible with steroids to avoid permanent loss of vision.
10. You have a sudden, severe headache and redness in one eye. A headache and a painful, red eye can be caused by a number of conditions that are not life-threatening, including corneal injury and eye inflammation. However, one form of acute glaucoma, involving rapid buildup of pressure on the optic nerve, can occur suddenly with these same symptoms. Left untreated, it can lead to irreversible vision loss. So just in case, you must get to an ER.
Margery D. Rosen is a freelance writer specializing in health, psychology and relationships.
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