Are Headaches a Sign of Stroke?

Table of Contents
View All
Table of Contents

A severe headache that comes on suddenly can be a sign of a stroke, though there are other possible causes as well. Regardless, most causes of these so-called thunderclap headaches can be serious. If you experience one, call 911 or go to your nearest emergency room at once.

This is true whether this is your only symptom or you have others. For example, a stroke-related headache may be accompanied by dizziness, slurred speech, and blurred vision.

This article goes over the connection between headaches and stroke, including how a stroke headache feels and how that differs from a migraine. It also details other signs of stroke that may or may not accompany headache, as well as why fast treatment is critical.

Do You Get Headaches Only During Slumber?. Hero Images/Getty Images

How Stroke Causes Headaches

Strokes are a medical emergency that happens when blood flow to the brain is interrupted. This is what causes headache. There are two types of strokes, both of which can cause this symptom:

  • Ischemic stroke happens when the artery that supplies oxygen-rich blood to the brain gets blocked. The lack of blood flow causes brain cell death.
  • Hemorrhagic stroke happens 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. It's common for patients with this type of stroke to only have a sudden, severe headache as a symptom.

A transient ischemic attack (TIA) is a temporary interruption of blood flow in the brain that is sometimes called a "mini-stroke." It comes on suddenly and gets better fairly quickly. (Most TIAs last 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, including headache. No matter how mild the symptoms are, a TIA should be treated just like a stroke and can be an early warning sign of a full stroke.

What Does a Stroke Headache Feel Like?

People often describe a stroke headache as the worst headache of their life. The pain is severe and cannot be ignored. It hits hard and fast, coming on within seconds or minutes.

The location of the headache pain depends on where the stroke is occurring:

  • Strokes that start in the carotid artery (a major artery in the neck that brings blood to the brain) can cause a headache in the forehead.
  • Strokes in the vertebrobasilar system (which supplies blood to the back of the brain) may cause a headache at the back of the head.

Studies have found that many patients have a headache before they have a stroke.

Stroke Headache vs. Migraine

As migraine headaches are also severe, you might wonder if you are experiencing one of them instead. There are some key differences between the two that are worth noting:

Stroke Headaches
  • Pain is severe and fast-hitting

  • Pain tends to be steady

  • Starts without warning signs

  • Pain comes on gradually

  • Pain tends to be throbbing

  • May experience certain sensory symptoms before the pain strikes (e.g., tingling skin, seeing flashes of light)

Rarely, a migrainous stroke can occur. In this case, a person experiences both a migraine with aura (head pain and sensory disturbances) and a stroke.

Other Stroke Symptoms That Accompany Headache

When a headache is caused by a stroke, people usually have other stroke symptoms as well, such as:

  • 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

Importance of Immediate Stroke Treatment

If you have a severe headache that hits you suddenly and is unlike any pain you've had before, or you have other signs or symptoms of a stroke, do not delay in getting emergency medical attention.

A stroke can be fatal and every minute matters. Strokes damage the brain, and early diagnosis and treatment are key for preventing the long-term effects of the condition.

Even if you're not having a stroke, a sudden, extremely painful headache can be a sign of other serious medical conditions (e.g., bleeding or infection in the brain) that also need to be treated right away.


Think FAST With a Stroke


Headaches that are brought on by strokes are often sudden and intense. The headache usually happens along with other classic stroke symptoms, like weakness, numbness, dizziness, and slurred speech.

Strokes are a medical emergency. If you have any stroke symptoms, including a headache that is sudden and severe, call 911 or go to your nearest emergency room.

8 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. Connolly ES, Rabinstein AA, Carhuapoma JR, et al. Guidelines for the management of aneurysmal subarachnoid hemorrhageStroke. 2012;43(6):1711-1737. doi:10.1161/str.0b013e3182587839

  3. American Stroke Association. TIA.

  4. National Health Service (UK). Transient ischemic attack (TIA).

  5. 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

  6. Lebedeva ER, Ushenin AV, Gurary NM, Gilev DV, Olesen J. Sentinel headache as a warning symptom of ischemic strokeThe Journal of Headache and Pain. 2020;21(1). doi:10.1186/s10194-020-01140-3

  7. Cedars-Sinai. Migrainous stroke.

  8. Centers for Disease Control and Prevention. Stroke signs and symptoms.

Additional Reading

By Colleen Doherty, MD
 Colleen Doherty, MD, is a board-certified internist living with multiple sclerosis.