- Causes
- Primary headaches
- Secondary headaches
- Home treatment
- Warning signs
- When to get care
- Bottom line
Just about everyone has experienced a headache.
They’re so commonTrusted Source that almost 2 out of 3 children have one before age 15, and over 9 out of 10 adults report having had at least one.
Headaches can range from mildly annoying to debilitatingly painful.
A “splitting headache” rises to the level of moderate to severe pain. It’s a headache that won’t be ignored and gets in the way of normal functioning.
Read on as we explore what causes splitting headaches, how to treat them, and the signs that you should see a doctor.
What can cause a splitting headache?
There are two main types of headache: primary and secondary.
Primary headaches include:
- migraine
- cluster
- tension
There’s no underlying condition causing them, although they can be triggered by things like:
- alcohol, particularly red wine
- bright or flashing lights
- certain foods
- skipping meals
- stress and anxiety
- sleep disturbances
- lack of sleep
- stress on your shoulder, neck, or jaw muscles
- weather changes
Secondary headaches are a symptom of an underlying medical problem, such as:
- infection
- head trauma
- stroke
Let’s take a closer look at both primary and secondary headaches.
Primary headaches
Primary headaches can be divided into three categories.
Tension headache
Tension headaches are the most common type of headache. True to their name, tension headaches tend to occur when you’re stressed or anxious. Women are twice as likely to have tension headaches as men.
These headaches are associated with muscle contractions in and around your head and neck area. Typical symptoms of a tension headache include:
- pain that feels like a tight band of pressure around your head
- tenderness and pressure around your forehead
Migraine
Migraine attacks involve throbbing pain in one side of the head. Episodes generally last 4 to 72 hours. Other symptoms can include:
- blurred vision
- fatigue
- light, sound, or odor sensitivity
- mood changes
- nausea
- vomiting
- pain that gets worse with physical activity
- neck pain and muscle aches
Migraine with aura includes visual disturbances before or during the attack. Aura can also occur without pain. Women get migraine attacks at three timesTrusted Source the rate of men.
Cluster headache
A cluster headache occurs as a series of splitting headaches, usually occurring over a span of several weeks. They can last anywhere from a few minutes to several hours.
These headaches tend to recur less frequently than migraine episodes. Like migraine, they involve pain on one side of the head and can include aura and nausea. Other possible symptoms include:
- changes in blood pressure and heart rate
- redness, swelling, tearing, or pain around the eye
- sensitivity to light, sound, or odor
Cluster headaches are more commonTrusted Source in men than women. They’re also more common in smokers than nonsmokers.
Secondary headaches
Secondary headaches are those that occur due to an underlying medical condition or other cause. Let’s look at some of the most common causes of these headaches.
Medication overuse
It’s not uncommon for people with recurrent primary headache to develop medication overuse headaches.
This happens when you take pain relievers too frequently. These headaches are also known as “rebound headaches” and can become chronic.
Medication overuse headaches can cause throbbing pain in your head. The pain may subside when you take pain relief medication but then return once the medication has worn off. Other symptoms may include:
- nausea
- vomiting
- trouble concentrating
- restlessness
Head trauma
You can develop a splitting headache after a head injury due to:
- concussion
- hematoma
- inflammation causing increased pressure on the brain
The headache pain can start right after the injury or several days or weeks later. The pain can be centered at the site of injury, but it may affect your whole head.
Other symptoms can include:
- memory loss
- confusion
- seizures
Infection
Infections that reach your brain can cause head pain due to inflammation.
Encephalitis is inflammation of the brain. Bacterial meningitis is an infection in membranes around the brain and spinal cord. Both can involve sudden, severe headache.
Other symptoms of brain infection may include:
- confusion
- drowsiness
- nausea
- vomiting
- stiff neck and back
- fever
Stroke
A headache that comes on suddenly and ratchets up to maximum intensity within minutes can be a sign of stroke.
A hemorrhagic stroke is when an artery bursts and spills blood into surrounding tissue.
An ischemic stroke happens when blood flow is restricted by a blockage, causing nearby brain cells to die.
Other signs of stroke include:
- weakness or numbness, especially on one side of the body
- trouble speaking or slurred speech
- mental confusion
- loss of balance or coordination
- trouble walking
- dizziness
- vision changes
Brain aneurysm
A brain aneurysm occurs when an artery that balloons out. If the artery ruptures, it can cause a sudden, very severe headache.
Other symptoms of a brain aneurysm can include:
- neck stiffness
- blurry or double vision
- drooping eyelid
- dilated pupil
- difficulty walking
- seizure
- nausea
- vomiting
- change in mental state
- loss of consciousnesses
Brain tumor
A brain tumor pressing against nerve tissue and blood vessels usually causes inflammatory fluid pressure, or edema, and may interfere with blood flow in the brain.
It may also disrupt the flow of cerebrospinal fluid, causing increased pressure on the brain.
Headache pain due to a brain tumor tends to be worse in the morning and aggravated by straining, coughing, or sneezing. Other symptoms can include:
- changes in mental functioning
- seizures
- blurry or double vision
- confusion
- vomiting
Fewer than 1 in 1,000Trusted Source people under age 50 who report isolated headache pain are diagnosed with a brain tumor.
Other secondary headache causes
Other possible causes of secondary headache include:
- structural or traumatic abnormalities of the head, neck, or spine
- high blood pressure
- a side effect of medication or other treatment
- spinal fluid leak
- substance withdrawal
- trigeminal neuralgia
Treatment for a splitting headache
In most cases, headache pain can be relieved with home treatment.
If your headache isn’t accompanied by other concerning symptoms, the following at-home treatments may help ease your headache pain:
- Take a nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), or aspirin.
- Drink plenty of water.
- Massage the tight muscles in your shoulder or neck.
- Apply an ice pack or warm compress where it hurts.
- Do breathing exercises or yoga to relax.
- Drink a little caffeine.
- Rest in a dark, quiet room.
If you have chronic headaches, try keeping a daily journal. By tracking your diet, activity, mood, and sleep habits, you may be able to determine what triggers your headaches.
Symptoms to watch out for
Although they can be debilitating, primary headaches aren’t life threatening.
However, secondary headaches can be. That’s why it’s important to pay careful attention to any symptoms that accompany your headache.
Symptoms to watch out for include:
- a headache that’s sudden or severe
- confusion
- fever
- numbness or weakness on one side of your body
- seizure
- severe vomiting
- sleepiness, fainting, loss of consciousness
- shortness of breath
- stiff neck
- trouble walking
- vision loss
GET IMMEDIATE CARE
The above symptoms could be signs of stroke, ruptured aneurysm, or brain inflammation.
A splitting headache accompanied by any of these symptoms should be considered a medical emergency. Call 911 or your local emergency services immediately.
When to see a doctor
It’s not usually necessary to see a doctor for a headache, especially if it goes away with home treatment.
However, there are situations when you should definitely check in with your doctor about your headache. See your doctor right away if:
- you’ve had any type of injury to your head
- your headache has gotten progressively worse over days or weeks
- over-the-counter medications or home remedies don’t help
- your headaches happen frequently
- you have other unexplained symptoms
- you’re over 50 and headaches are a new development
- you just started getting headaches and have a history of cancer or HIV
- your headache feels different than other headaches you’ve had before
If you have these concerning features, your doctor will check for underlying conditions before diagnosing primary headache.
Treatment for your headache will depend on the type of primary headache you have or the underlying condition that your doctor diagnoses.
The bottom line
A splitting headache is a severe headache that makes it difficult to function. There are two main types of headache: primary and secondary.
Migraine, cluster, and tension headaches are examples of primary headaches.
Secondary headaches are those that occur due to an underlying medical condition. In some cases, secondary headaches can be a symptom of serious, even life-threatening conditions.
There are several home remedies that may help relieve your headache pain. If you have migraine or chronic primary headache, more powerful treatments may be necessary.
See your doctor or get immediate medical attention if you have unexplained, severe headache pain and other troubling symptoms, such as:
- numbness
- difficulty speaking
- confusion
- seizures
- vision changes
