Is It a Headache or a Stroke?

Is It a Headache or a Stroke?

When you get a headache, you probably take aspirin and try to shrug it off. But sometimes headaches are warning signs of something more serious like a stroke, a condition that’s similar to a heart attack but affects the brain.

More than 795,000 Americans have strokes every year, and of those, about 130,000 die from it. According to one survey, while 60 percent of people knew that severe headache with no known cause could signal stroke, only 38 percent of people could recognize all the major symptoms and knew to call 9-1-1 right away.

Unfortunately, knowing when your headache spells trouble can be difficult. Here’s what you need to know about the two main types of stroke, as well as why some headaches are more cause for concern than others.

Pay attention to these symptoms
About 85 percent of strokes are ischemic, which occur when a blockage prevents a blood vessel from providing blood to the brain. Most ischemic strokes don’t cause headaches.

But some types, such as arterial dissections, which are tears in the wall of an artery supplying the brain that leads to a blockage, and cerebral venous sinus thrombosis—a blockage in veins draining blood from the brain—can produce a splitting headache.

Be on the lookout for other symptoms to determine if you may be having an ischemic stroke. Other symptoms of an arterial dissection include:

  • Facial pain or numbness on the same side as the headache
  • Numbness on the opposite side of the body to the headache

People with headaches due to venous sinus thrombosis may also have blurry vision and seizures.

Why the worst headache of your life is a red flag
The remaining 15 percent of strokes are hemorrhagic. These are brain bleeds, and there are two types: an intracerebral hemorrhagic stroke and a subarachnoid hemorrhagic stroke.

An intracerebral hemorrhagic stroke, which accounts for around 12 percent of all strokes, occurs when a weakened blood vessel or aneurysm bursts, causing a brain bleed. Hypertension is the most common risk factor for an intracerebral hemorrhagic stroke.

A subarachnoid hemorrhagic stroke occurs when a bulge in a blood vessel—an aneurysm—within the covering layers of the brain ruptures, causing bleeding in the space surrounding the brain. While subarachnoid hemorrhagic strokes are less common, accounting for around 3 percent of all brain attacks, their results are often devastating. Half of all patients die within the first six months, with between 15 and 30 percent of people with a brain bleed dying before even reaching the hospital.

An intracerebral hemorrhage, which most often occurs in people with high blood pressure or less frequently from an underlying blood vessel malformation, causes sudden, severe headaches. People with subarachnoid hemorrhagic strokes often complain of suddenly having the worst headache of their lives.

How strokes are treated
Ischemic strokes are usually treated with drugs to dissolve the blood clot. Minimally invasive catheter-based treatments—similar to stents used on heart attack patients—can also open blocked vessels in people with brain attacks.

While brain surgery was once the only option for hemorrhagic strokes, less-invasive options are now available, including endovascular treatments with coils, stents and flow diverters for brain aneurysms, and endoscopic treatments with vacuum suction devices for draining brain bleeds.

How to reduce your risk
Unfortunately, some risk factors for stroke like age can’t be changed. Stroke risk doubles with each decade after age 55, and your risk of stroke is greater if you have a family history of the disease. Fortunately, there are some things you can do to lower stroke risk including:

  • Lose weight
  • Exercise regularly
  • Eat a healthy diet
  • Watch your blood sugar
  • Lower your cholesterol
  • Watch your blood pressure
  • Don’t smoke, and avoid being around second-hand smoke

If you think you or someone you know is having a stroke, remember the acronym F.A.S.T.— Face drooping, Arm weakness, Speech difficulty and Time to call 9-1-1. If you experience or notice symptoms like facial dropping, arm weakness or speech difficulty, then call 911 immediately. It might be the difference between life or death.

Updated by Patrick Sullivan on May 25, 2017

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