Does Stroke Cause Headaches?

Stroke is a serious and potentially fatal event that occurs in the brain and is usually accompanied by a very severe headache. People can experience two different types of stroke. In the first, a blood vessel in the brain, or that leads to the brain, bursts. This causes blood to leak into the brain tissue or the spaces between the brain and the skull. Any pressure on the brain causes pain and a headache develops immediately after a blood vessel has ruptured. The other type of stroke is called an ischaemic stroke. This occurs when a blockage in an artery supplying the brain cuts off the blood supply to a part of the brain tissue, causing it to die very quickly. This type of stroke can also cause a severe headache.

Sub Arachnoid Haemorrhage and Headache

This stroke is caused by blood leaking into the space between the meninges, the thin membranes that surround the brain. This space is normally filled with cerebrospinal fluid and its volume is tightly controlled. A sudden increase in volume, even with a small bleed caused by the rupture of a minor blood vessel, has a major effect. The main symptom is an instant and incredibly severe headache which is disabling and often causes intense nausea, vomiting and collapse. If blood leaks into the spinal fluid, pain can also occur in the neck and in the back.

Brain Haemorrhage and Headache

Bleeding within the brain itself is also associated with a very severe headache that comes on very quickly. The bleeding may follow a blockage in a blood vessel and is also accompanied by death of brain tissue. Other effects include paralysis, loss of consciousness, loss of speech and confusion.

Brain Aneurysm and Headache

An aneurysm describes the ballooning out of an artery, which then bursts due to the pressure of blood inside. This can occur when the wall of the artery becomes weakened for some reason. The artery can develop the balloon long before the rupture, causing a headache that tends to persist for weeks, and no cause can be found to explain this sudden occurrence of regular headaches. Brain aneurysms are more common in people over 60. If daily headaches or constant headaches start suddenly with no explanation, doctors and neurologists often suggest a brain scan to find out if an aneurysm is present.

When the aneurysm bursts, the bleeding into the brain tends to be sudden and severe and causes a headache immediately. This has been described by the people who have experienced it as the worst headache they have ever known.

Vascular Problems in the Brain and Headache

Another, rarer type of stroke is caused by a malformed blood vessel network in the brain. During early life, there are no symptoms but someone with tangled blood vessels is more likely to experience ruptures of small vessels as they get older. This ‘mini strokes’ can cause severe and regular headaches. This type of stroke is different to a transient ischaemic attack, which can also be called a mini stroke. Vascular malformation strokes tend to cause other symptoms including fits and the perception of strange noises that follow the rhythm of the pulse.

Headache and Ischaemic Stroke

Ischaemic stroke, which occurs when a blood vessel in the brain becomes blocked by a fatty plaque or blood clot, is very common in older people in developed countries. It is a major cause of death and disability in the UK. Although this type of stroke does cause headache, it also tends to cause paralysis, usually down one side of the body, loss of speech, confusion and loss of consciousness.

Most Headaches Do Not Indicate Stroke

Although very severe headaches are associated with strokes of different kinds, having a headache is usually not a sign of stroke. Most people get a headache at some time in their lives and the vast majority of people have regular headaches. The time to seek medical advice is when a headache is very severe and comes on with no warning and doesn’t go away and if any other symptoms of stroke are present. As with heart attacks, prompt treatment can make a big difference to survival and also to the level of recovery that occurs afterwards.