How a Headache May Be a Sign of a Stroke

By
Colleen Doherty, MD
Colleen Doherty, MD
Colleen Doherty, MD
Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.
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Updated on May 16, 2020
Medically reviewed
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 by
Huma Sheikh, MD
Huma Sheikh, MD
Medically reviewed by Huma Sheikh, MD

Huma Sheikh, MD, is a board-certified neurologist, specializing in migraine and stroke, and affiliated with Mount Sinai of New York.

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A stroke is a medical emergency. Sometimes it may also be associated with a headache.

Learn about the types of stroke and how a stroke-related headache is different from a primary headache.

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Types of Stroke

Strokes occur when blood flow to the brain is interrupted. There are two types of strokes. Both are medical emergencies, and both may cause a headache.

  • Ischemic stroke occurs when an artery that supplies oxygen-rich blood to the brain becomes blocked. This lack of blood flow causes brain cell death.
  • Hemorrhagic stroke occurs when an artery in the brain bursts. This leads to bleeding into the brain. A common example of a hemorrhagic stroke is a subarachnoid hemorrhage. A severe headache is the only symptom for about a third of people with this type of stroke.
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Think FAST With a Stroke

Headaches and Strokes

Between 7% and 65% of people who have a stroke report that they had a headache beforehand. The location of the headache pain may depend on where the stroke is occurring.

For instance, strokes that arise within the carotid artery (a major artery in the neck that brings blood to the brain) sometimes produce a headache in the forehead.

On the other hand, strokes in the vertebrobasilar system, which supplies blood to the back of the brain, may produce a headache at the back of the head.

People will often describe a stroke headache as the "worst of my life." Or they might say that it appeared like a "thunderclap"—a very severe headache that comes on within seconds or minutes.

The pain associated with a stroke headache generally doesn't throb or develop gradually like a migraine. Rather, it hits hard and fast.

Symptoms

Headaches that occur with a stroke typically occur with other stroke symptoms. These include:

  • Weakness on one side of the body
  • Numbness on one side of the body
  • Dizziness (vertigo) or loss of balance
  • Slurred speech
  • Inability to write or manage fine hand movements
  • Difficulty understanding others
  • Double vision or blurred vision

Stroke vs. Migraine

With a stroke headache, you may notice a loss of sensation (such as feeling or vision).

By contrast, if you have a migraine, you may notice increased sensations (such as auras, flashing lights, or tingling skin).

Mini-Stroke (TIA)

A transient ischemic attack (TIA) is a kind of stroke that people often mistake for a migraine. That's because it comes on suddenly and often resolves fairly quickly. This type of stroke is also called a "mini-stroke" because the interruption of blood flow is only temporary.

Most TIAs last for 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. No matter how mild the symptoms, a TIA should be treated just like a stroke. A TIA is often an early warning sign of a full stroke.

When to Go to the Hospital

If you believe you are experiencing symptoms of a stroke, call 911. Early treatment is the key to preventing the long-term effects of a stroke.

This is especially true if a severe headache hits suddenly and is unlike anything you've experienced before.

Even if your symptoms are uncertain, seek emergency care if you have an underlying risk for a stroke. These risk factors include:

Summary

Headaches can sometimes be a sign of a stroke. Headaches that are brought on by strokes are often sudden and intense.

Stroke headaches usually occur with other classic stroke symptoms, like weakness, numbness, dizziness, and slurred speech.

Strokes are a medical emergency. If you experience any stroke symptoms, including a headache that is sudden and severe, call 911 immediately.

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

  1. 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

  2. Carolei A, Sacco S. Chapter 47 - Headache attributed to stroke, TIA, intracerebral haemorrhage, or vascular malformation. Handbook of Clinical Neurology. 2010;97:517-528. doi:10.1016/S0072-9752(10)97047-4

  3. 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

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