Severe Headache

Severe headache is localized unilaterally, and typically occurs in bursts over a period of several weeks to several months. While common headaches can cause some discomfort, such headache is debilitating. It was called "suicidal headache" just because the pain is unbearable. However, it does not cause permanent damage.

It is relatively rare, more common in men than in women.

The cause of severe headache is not known. It seems to have a genetic component, because children from parents suffering from this disease are more likely to develop it.

Severe headache seems to be caused by a dysfunction in the hypothalamus (area of the brain) although a specific problem or an anomaly at this level, which react to certain triggers, has not been clearly identified.

Drinking alcohol, sleep apnea (stopping breathing during sleep), stress, fatigue or some vasodilators (which dilates blood vessels) can be considered triggers of severe headache or worsen the evolution cycle once started.

Most individuals with severe headache have 1 or 2 cycles per year, each lasting 1 to 3 months. After the cycle ended, a period of remission from 6 months to 2 years follows.

Severe headache may begin while sleeping, usually after 2 to 3 hours of sleep.

Unilateral headache feels like a stab, usually also around the eye. It may extend up to the temple, forehead, cheekbones, upper jaw or the mandible on the affected side. Sometimes severe headache is associated with nasal obstruction, runny nose, and watery eyes.

Pain intensifies quickly - usually 5 to 10 minutes after onset. It may continue for days, weeks and even months until symptoms resolve completely. Another cycle occurs after an interval of several months to several years. Exceptionally, the pain can become chronic.

During such a cycle, the individual may be anxious, agitated and unable to stay in one place. Some patients improve their pain by various methods.

At the end of the painful episode, the individual is physically and mentally exhausted.

Over time, severe headache can evolve towards worsening, painful episodes becoming longer and shorter periods of remission. There are people who may have a single episode of headache. A cycle is on average up to 8 painful bursts per day for 6 to 12 weeks, followed by a free interval that can take weeks, months or even years.

Patients should call emergency services immediately if:

- There is a sudden headache, severe pain different from other types of pains experienced in the past;

- muscle weakness, paralysis, numbness, blurred vision, difficulty speaking, confusion or behavioral changes are noticed;

- Intense pain caused by severe headache can lead to suicidal thoughts.

- Pain comes after a recent trauma to the head;

- Headache is installed gradually and is accompanied by confusion, lethargy, loss of sphincter control (involuntary loss of urine or feces).

We recommend consulting the family doctor if:

- The patient is woken up repeatedly by severe head pain, with special occurrence during night or early morning

- The first episode of severe headache by the age of 50 years

- Changing in the pattern of headaches

- Headache occurs after exercise, sexual intercourse, coughing or sneezing

- Medications do not relieve pain