The heart and blood vessels keep the nerve pathways of the brain and central nervous system supplied with oxygen-rich blood. When those vessels become blocked, inflamed, or damaged, they can cut off this blood supply and permanently damage nerve fibers and cause infarction, or death, of brain tissue. In people with a history of heart and circulatory problems, sudden or severe head pain can be a sign of more serious problems and should be immediately evaluated by a physician or emergency health care professional.
People with cerebral arteriosclerosis frequently experience headache. Arteriosclerosis occurs when the artery walls thicken and become inflexible. If this occurs in the cerebral blood vessels, it restricts blood flow and can cut off the oxygen supply to the brain, resulting in a stroke. It can also increase the risk of an aneurysm, a weakened blood vessel wall that may be distended and is in danger of rupture, causing hemorrhage, or bleeding on the brain.
Severe and sudden headache is a warning sign of aneurysm and should be evaluated by a medical professional as soon as possible.
Cerebral venous sinus thrombosis, or the formation of clots within the large draining veins of the brain, can also trigger severe head pain. This is a rare disorder associated with conditions that cause hypercoagulability, or excessive clotting, of the blood. These conditions include certain genetic traits, dehydration, infection, contraceptives, and the immediate postpartum period.
Be aware of the warning signs of stroke: weakness and numbness (often on one side of the body), mental confusion, difficulty speaking, balance problems, vision loss, and a sudden and severe headache. Receiving “clot busting” drugs within three hours after the first signs of a stroke reduces long-term disability in stroke patients.
A dissection, or tear, in the inner wall of the carotid artery, the major blood vessel located in your neck, causes blood to leak into the artery wall, resulting in head and neck pain. Carotid dissection can also cause a transient ischemic attack (TIA) or a stroke, as the carotid artery narrows and diminishes the blood supply to the brain.
Certain drugs prescribed to treat cardiovascular disease, including blood pressure medications (antihypertensives and vasodilators), may also cause headaches in some people. If your blood pressure medication is causing chronic headache, talk to your doctor about a dosage adjustments and other treatment alternatives.
Transient Ischemic Attack and Stroke
When compared to those without migraine, men with migraine disorder have an increased risk for cardiovascular disease and heart attack. Among women, those who have migraine with aura are at an increased risk for cardiovascular disease, heart attack, transient ischemic attack, and stroke.
When blood flow to the brain is reduced, a transient ischemic attack, or “ministroke,” can occur. The warning signs of TIA are the same as those of stroke — weakness, numbness, confusion, vision loss, difficulty speaking, severe headache — except they disappear in minutes to hours.
Because all of these are also found in migraine, there is a possibility of misdiagnosing TIA as migraine or vice versa. If symptoms come on gradually, migraine is the most likely explanation, especially in young people. If head pain and other symptoms are sudden, with maximal severity within seconds to just minutes, TIA or stroke must be considered.
TIA is usually caused by a blockage in the carotid artery or in the smaller blood vessels of the brain that restricts blood flow. This can be due to clotting or to narrowing of the arterial walls. An estimated 20 percent of people who experience a TIA have a stroke within two years. Aspirin and other anti-platelet drugs, anticoagulant drugs (blood thinners) in the setting of certain associated conditions of the heart or blood vessels, surgery to open clogged blood vessels, angioplasty and stents (a wire mesh tube that holds the artery open) can also reduce the risk of TIA and stroke.