Most of us have headaches from time to time. While they can be painful, they usually do not indicate that something serious is going on. There are certain headaches however, that you should pay attention to and seek medical care.

1) Thunderclap headache

A thunderclap headache is a sudden, extremely painful headache that develops in 60 seconds or less — like a clap of thunder. Typically, it eases off in about an hour or so, but can continue for up to 10 days.

The concern with this headache is that you could be having a bleed into your brain from a ruptured blood vessel causing an intracranial hemorrhage. But it can also be caused by other problems such as a rapid rise in blood pressure, an infection in your brain, or as a result of sudden heavy lifting.

You may also have accompanying symptoms: nausea, vomiting, weakness, numbness, confusion, stiff neck or changes in vision.

It is also possible that the headache is a type of migraine called a crash headache, which feels similar to a thunderclap, or it may be caused by a less serious problem.

Only an examination by a doctor along with other tests such as a CT scan, MRI or spinal tap will help in diagnosis.

2) The worst headache ever

This is one of the sentinel signs that the headache is serious.

Combine that type of headache with being over the age of 50, or having a loss of consciousness or collapse. The combination could indicate that there is a subarachnoid hemorrhage caused by a ruptured cerebral aneurysm. This can lead to a stroke and cause brain damage.

Go to the emergency room and insist on having a CT scan of your brain, neurologist Richard C. Senelick, M.D. wrote in the Huffington Post.

3) Head injury headache

Headaches after an impact to the head are not uncommon. They can also indicate a concussion. Typically, headaches should steadily improve over four weeks after the injury.

However, a headache that gets worse could indicate bleeding between the brain and one of the layers covering it, causing a subdural hematoma.

“Symptoms may develop minutes, hours, or occasionally weeks after the injury.”(4)

4) Headache with a stiff neck or fever

A headache with stiff neck or fever is a classic symptom of meningitis. According to Emedicinehealth.com, only about 45 percent of adults get all three symptoms, but most people with meningitis do have at least one.

Other symptoms may include: sensitivity to light, seizures and a history of upper respiratory infection.

It is important to get medical care right away to determine whether the meningitis is bacterial or viral, so treatment can be initiated.

Conclusive diagnosis is made through a physical exam and a lumbar puncture.

Mayo Clinic has a headache symptom checker you can use here.

This link is not intended as a substitute for seeking medical care, but it can help you narrow down possible causes for your headache.

Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues.

Edited by Jody Smith