Secondary Headache

A headache is pain or discomfort in the region of the head or face. Headaches differ greatly with respect to pain quality, severity, location and frequency. Secondary headaches are headaches that are due to an underlying medical condition, such as a neck injury or a sinus infection. Rarely, a secondary headache may be a sign of a serious underlying medical condition such as:

  • brain infection such as encephalitis or an abscess
  • brain tumor
  • hydrocephalus
  • problems with the blood vessels (e.g. bleeding or inflammation such as temporal arteritis)
  • very high blood pressure

Signs and Symptoms

Symptoms of secondary headache are:

  • a new or different type of headache in someone over 50 years old
  • headache that wakes you from sleep
  • headache that worsens when changing posture, with exertion, or with a Valsava maneuver, such as coughing and straining
  • headache associated with chewing food

These symptoms warrant further investigation by a specialist. Other secondary headache symptoms may require immediate attention. These red flag symptoms include:

  • associated seizure or epilepsy
  • headache that occurs with a head injury
  • vomiting without nausea
  • headache that develops within seconds, known as a "thunderclap headache"
  • "worst ever" headache
  • inability to move a limb
  • slurred speech
  • mental confusion
  • visual loss or visual abnormalities
  • neck stiffness
  • fever
  • headaches in people with HIV, cancer or risk factors for thrombosis, also known as a blood clot

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