A sudden, severe headache unlike anything you have had before — especially with weakness, numbness, confusion, slurred speech, vision loss, fever, stiff neck, or seizure. These can be signs of stroke, brain bleed, or other emergencies.
A headache that comes on suddenly and reaches maximum intensity within seconds to minutes can indicate a brain bleed, aneurysm, or other emergency. Seek emergency care immediately.
Sudden weakness, numbness, slurred speech, vision loss, severe confusion, or seizure — these are not typical migraine features and require urgent evaluation.
May indicate meningitis (an infection of the membranes around the brain) or another infection. Especially urgent if recent infection, immune compromise, or unvaccinated status.
Any significant headache after a blow to the head — especially with vomiting, confusion, or loss of consciousness — needs evaluation to rule out bleeding.
New-onset headaches in older adults can indicate temporal arteritis (inflammation of blood vessels near the temples), vascular problems, or other conditions that need different evaluation than typical migraine.
A clear, sustained change in headache frequency, severity, or associated symptoms — especially with new neurological findings — warrants re-evaluation.
Acute glaucoma (a sudden pressure build-up in the eye) can present this way. Especially in older adults or those with risk factors. Needs urgent ophthalmologic evaluation.
Headaches in pregnancy — especially with high blood pressure, vision changes, or upper abdominal pain — can indicate preeclampsia (a serious blood pressure condition in pregnancy). Seek immediate care.
Most doctors genuinely want to help but have limited time. Making the most of your visit increases the chance of getting the right treatment plan.
A 1-3 month headache diary with frequency, severity, associated symptoms, and treatment response is the single most useful thing you can bring.
"How does migraine affect your daily life?" is more useful than a severity score. Mention missed work, canceled plans, lost sleep, family impact.
Including prescription medications, over-the-counter drugs, supplements, devices, behavioral approaches, and lifestyle changes. Bring actual medication bottles if possible.
One-sided or both? Throbbing or pressure? Light/sound sensitivity? Nausea? Aura? Duration? Triggers you have noticed?
Migraine has a strong genetic component. A family history of migraine strengthens the diagnosis.
Medication-overuse headache is common and treatable, but only if your provider knows what you are actually taking.
Including non-medication approaches. Procedures like TEMMA® exist for patients who have not found relief with standard treatments.
The main migraine types and how doctors tell them apart.
Read guideHow to find the triggers that actually affect you.
Read guideEvery option used today, from pills to procedures.
Read guideRed-flag symptoms and when to escalate care.
Read guideHormones, periods, pregnancy, and menopause.
Read guideHabits that make attacks less likely.
Read guideThe artery and membrane behind migraine pain.
Read guidePlain definitions for the terms on this site.
Read guide