From Strep to Stroke: Medical Conditions That Can Cause Headaches

Headaches Can Occur When You Have an Acute or Chronic Illness

Viral and bacterial infections are notorious for causing headaches: I frequently hear this complaint in the clinic. Illnesses like flu, COVID-19, sinusitis (face, forehead, between and behind eyes), and ear infections are the leading causes of acute headaches. Even strep and allergies can cause headaches.

These types of headaches may come and go or may be ongoing, lasting from hours to days until the illness finally dissipates. Want to know more? Read on about From Strep to Stroke: Medical Conditions That Can Cause Headaches.

A Person With a Severe Headache

What Physical Problems Can Cause Headaches?

Here are just a few medical causes of headaches:

• Everyday illnesses like the flu, strep, and sinus infections

• Fever

• Dehydration

• High Blood Pressure

• Glaucoma

• Anemia

• Thyroid problems

• Fibromyalgia

• Medication side-effects

• Head injuries

• Immune compromise

• Worst-case scenarios like a stroke, meningitis, or brain tumors: As clinicians, we were always reminded to refer patients with a severe, "worst headache I have ever had in my life" to the Emergency Room (that is a reminder to the reader as well).

  Learn more about causes here.

  
  

Treating the Potential Cause

Treatment of the underlying illness is essential to getting rid of these headaches. In the meantime, you can try any of the following for relief.

​

Over-the-Counter Medicines

NSAIDS: Ibuprofen (common: Advil, Motrin), naproxen sodium (common: Aleve, Naprosyn), and the combination of caffeine, acetaminophen, and aspirin (common: Excedrin, Goody’s Powder). These are probably the best choices for headaches. Try to take NSAIDs with a little bit of food (as simple as a cracker) to avoid stomach irritation. If your headache is minor, take the lowest dose. If it is moderate, take the higher recommended dose.

Acetaminophen (common: Tylenol). 

Take as directed over-the-counter if there are no contraindications.

Considered Natural Remedies

• Ginger

• Willow

• Peppermint

• Chamomile

• Lavender

• Caffeine

Prescriptive Treatment

Most providers will not prescribe medication for an acute headache when it is caused by an acute underlying illness. Over-the-counter medications will usually do the job. However, on rare occasions, they may be prescribed short-term: These include painkillers such as oxycodone or hydrocodone (combo opioids with Tylenol: Lortab, Percocet, and Vicodin) and Tramadol (i.e., Ultram). Because these are highly addictive, they are not the drug of choice for long-term pain.

From Strep to Stroke: Medical Conditions That Can Cause Headaches. Worst-case scenarios and Red Flags

• You have a “thunderclap” headache – sudden severe onset - a "10 out of 10" - go to ER

• ​Do not dismiss frequent or severe headaches, especially if accompanied by

  vomiting (especially projectile - a forceful outward-directed emesis )

• Double vision

• Change in your level of consciousness or change in behavior

• Recent head injury

• It is new and lasting for a few days (especially in the absence of a known viral or bacterial infection)

• Is excruciating

• Has become  chronic/ongoing and does not respond to medicines

• If headaches are occurring frequently after exercise

• Neck pain

• New onset of headaches after 50   (according to the American Headache Society)

• If you have more than one to two headaches a week or more than three to four per month 

• If you have less frequent headaches, but they are more severe and debilitating.

• Your headaches start to feel different than your "usual" headaches.

• Headaches accompanied by sudden weakness on one or both sides of the body

To learn more about headaches and their causes, visit the "headaches" page.