Is migraine headaches an emergency?
A typical migraine is usually not an emergency, but a headache that is the worst of your life, comes on like a thunderclap, or brings weakness, slurred speech, vision loss, confusion, or a stiff neck with fever is a medical emergency. Call 911 or go to the ER for those signs even if you have a migraine history.
Usually Not an Emergency
A migraine that follows your familiar pattern is painful and disabling, but it is rarely dangerous. If the throbbing pain, nausea, and light sensitivity match your past attacks and respond to your usual medication, you are almost certainly dealing with a migraine, not a life-threatening problem. The migraine itself does not damage the brain, and most attacks resolve within 4 hours to 3 days.
Red Flags That Make a Headache an Emergency
The concern is never the ordinary migraine. It is a headache that behaves differently and may signal bleeding, stroke, or infection. Go to the ER right away for any of these:
- Thunderclap headache that reaches maximum intensity within seconds to a minute. A sudden explosive headache can mean bleeding around the brain (subarachnoid hemorrhage) and needs a CT scan immediately.
- The worst headache of your life, especially if it is unlike any headache you have had before.
- Neurological signs: weakness or numbness on one side, facial drooping, trouble speaking or understanding words, sudden vision loss or double vision, loss of balance, confusion, or a seizure.
- Fever with a stiff neck, a rash, or severe light sensitivity, which can point to meningitis.
- A headache after a head injury, or one that wakes you from sleep or steadily worsens over days.
Call 911 Immediately For
Call 911 rather than driving yourself if a headache comes with signs of a stroke. Use the FAST check: Face drooping, Arm weakness, Speech difficulty, Time to call 911. A sudden severe headache with any weakness, numbness, slurred speech, or vision loss is treated as a stroke until proven otherwise, and minutes matter for treatment.
When It May Not Be an Emergency
A stable migraine that fits your usual pattern, has no neurological warning signs, and eases with rest and your normal treatment can generally be managed at home or through a virtual visit. The deciding question is whether this headache is different from your typical migraine. New, sudden, or unusual gets evaluated; familiar and stable usually does not.
For a complete guide, see our migraine headaches page. Bellaire ER is a 24/7 freestanding emergency room at 5302 Bellaire Blvd with on-site CT to rule out dangerous causes. Walk in any time or call (713) 660-0001.