The Possible Causes of Headaches

There are many causes of headaches. Generally, the following causes can be treated by your primary care physician or at home with over-the-counter medication. If you need help after-hours, you can contact Rice Er’s Call-a-Doc line to speak to a board-certified physician.  

• Stress
• Muscle tensions
• Sinus pressure
• Food sensitivity
• Chronic or episodic migraine
• Chronic or episodic cluster headaches

When the headache hits, follow the instructions your health care professional has prescribed in the past. This may be taking a prescription painkiller or over-the-counter medication, such as ibuprofen (Motrin or Advil), or acetaminophen (Tylenol).

When you Should go to the ER for your Headache

Although most headaches can be treated with over-the-counter medication, headaches that do not respond to OTC treatment or are accompanied by the symptoms below may be symptoms of more serious illnesses.

You need to head to an ER if you have a headache that comes suddenly, does not respond to your OTC medications, or is accompanied by the following symptoms:

• Your migraine seems to be more severe than usual or there are new symptoms along with it. This may indicate a stroke, an aneurysm, or a brain infection such as meningitis.
• Your headache seems to start with a “thunderclap.” You are hit with a sudden jolt of pain. Go immediately to the emergency room. This may be a sign of a stroke which needs treatment as soon as possible.
• Your headache is “intractable.” The migraine or headache lasts more than 72 hours, which is three days, and the pain is not relieved with any medication.
• Vision changes
• Dizziness or fainting
• You are unable to stand even if you hold on to something.
• High fever
• Confusion
• Stiff neck
• Muscle weakness
• Slurred speech
• Nausea and vomiting
• Inability to eat or drink
• You are over 50.
• Your headache was caused by a fall or other type of accident.
• A cough makes your headache worse.
• Your pupils are dilated.
• One eyelid droops.

If you ae unable to talk when you have a migraine, you should get a medical ID bracelet that includes your migraine history and generally required treatment.

There are some severe conditions that can cause a headache. That can include:

• Stroke
• Meningitis
• Aneurysm
• Brain tumor

What to Expect at the Stand-Alone Rice ER

At the stand-alone Rice Emergency Room, you will find board-certified physicians and other staff members who are specially trained to treat all types of illnesses. They commonly see people with headaches and know what tests are needed and how to quickly identify serious causes of headaches, like strokes and aneurysms, that need immediate treatment.

Wait times at Rice ER are far shorter than the wait times associated with hospital-based ERs. Generally, patients talk with a board-certified physician within minutes of their arrival, not hours.

Tests and Treatments Available at Rice Emergency Room

Rice ER uses the same diagnostic tools used by hospital-based ERs. Many tests may be performed to either identify the cause of your headache or rule out a possible cause. The physician will determine which tests are needed for your specific symptoms. Those tests may include:

• An eye exam if you report any vision changes.
• CT scan and other imaging tests like an MRI of your brain.
• Blood, urine, or other lab test to check for diabetes, thyroid problems, or infections that are known to cause headaches.

When the cause of your migraine or headache is identified, the ER physician will provide whatever treatment he or she deems appropriate. If hospitalization is required, Rice ER has an agreement with hospitals for the transfer of patients directly to their hospital bed without going through the hospital ER for evaluation.