Headaches

For all ages

The rash glass test

This is often used to determine if there is any evidence of meningitis or septicaemia (sepsis). A rash that does NOT fade under pressure (e.g. when the glass is pressed down onto the skin) can be suggestive of these conditions. Meningitis or sepsis can be life-threatening conditions, therefore immediate medical care and assessment is required. We cannot see patients immediately in our GP surgeries, hence we ask the patients to go to A&E departments.

Meningitis/meningococcal

This is a serious conditions that is often associated with fevers, headaches, rash which does not fade under pressure. Symptoms may also include a stiff neck or intense head/eye pain when looking at light (this is called photophobia).

This needs to be seen by a clinician early as it can cause serious complications and needs treatment as soon as it is identified.

Blurred vision/double vision

The most common cause of headaches with visual issues is migraines. Migraines can be different for different people, and often include very bad headache with a throbbing pain on 1 side of the head.

Patients may also get warning signs you're about to have a migraine (called an aura), such as problems with your sight, such as seeing zigzag lines or flashing lights, numbness or a tingling that feels like pins and needles, feeling dizzy, difficulty speaking

Migraines usually last between 2 hours and 3 days, with some symptoms (such as feeling very tired) starting up to 2 days before the head pain starts and finishing after the headache stops.

Sudden, severely painful headaches - the ‘thunderclap’ headache

The reason we ask about sudden, severely painful headaches is because of the medical emergency known as subarachnoid haemorrhage (SAH). The main symptoms of a subarachnoid haemorrhage include:

• a sudden severe headache unlike anything you’ve experienced before
• a stiff neck
• feeling and being sick
• sensitivity to light (photophobia)
• blurred or double vision
• stroke like symptoms – such as slurred speech and weakness on one side of the body
• loss of consciousness or convulsions (uncontrollable shaking)

This type of headache will come on instantly, and be completely different to any type of headache they have had before. It is often called a ‘thunderclap’ headache. Patients experiencing these symptoms need to call 999 and ask for an ambulance immediately as it is a life threatening condition.

Temporal arteritis / giant cell arteritis

This is another conditions that is important is seen promptly by clinicians. It is often associated with frequent, severe headaches, with pain or tenderness at the side of the head (temples) or on the scalp, or pain in the kaw when eating or talking. It can also have double vision.