Severe Headache After Bathing: When to Seek Medical Attention?

Q: Severe Headache After Bathing: When to Seek Medical Attention?

Hello： You mentioned that your father experienced "a sudden severe headache starting the moment he stood up from a squatting position... <br>He reported feeling an unprecedented intense headache that radiated from both temples to the entire head, accompanied by the sound of his b

Headache-related issues?

Hello, Dr.
Jiang:
My father has a habit of drying the bathroom walls and floor after showering to prevent slipping.
This evening, while he was wiping the water off the walls, he suddenly experienced a severe headache and felt a heat sensation in his head as he stood up from a squatting position.
He left the bathroom to rest in the living room.
We noticed that his face was flushed, and my mother was concerned that his blood pressure might be elevated, so she immediately took his blood pressure, which was 143/83/73.
After realizing he had just showered, we waited 20 minutes and measured it again, which was 120/80/71.
My father usually has low blood pressure, so these readings are somewhat unusual for him.
During this time, the redness in his face gradually subsided, leaving only his ears slightly red.
He reported experiencing an intense headache like he had never felt before, with pain radiating from both temples throughout his head, accompanied by a pulsing sound resembling his heartbeat or blood vessels "thumping." His face felt warm, but he did not break out in a cold sweat, and his vision was somewhat blurry.
He was also hiccuping, but after sitting down and resting for a while, he slowly began to feel better.

Since he has never experienced anything like this before, I would like to ask the doctor if it would be advisable for him to go to a major hospital for further detailed examination.

Lin Hsuan, 20~29 year old female. Ask Date: 2022/04/05

Dr. Jiang Junyi reply Neurology

Hello: You mentioned that your father experienced "a sudden severe headache starting the moment he stood up from a squatting position...
He reported feeling an unprecedented intense headache that radiated from both temples to the entire head, accompanied by the sound of his blood vessels or heartbeat 'thumping,' facial flushing without cold sweats, blurred vision, and persistent hiccups, which gradually improved after resting for a while." This type of symptom is referred to as "thunderclap headache."
The characteristics of thunderclap headache include:
1.
Sudden onset, reaching maximum intensity in less than 1 minute.
2.
Duration of 1 hour to 10 days, with irregular recurrences in the following weeks or months.
Potential causes range from benign tension-type headaches, migraines, and trigeminal autonomic cephalalgias to more serious conditions such as subarachnoid hemorrhage, cerebral venous sinus thrombosis, carotid artery dissection, spontaneous intracranial hypotension, stroke, meningitis, and reversible cerebral vasoconstriction syndrome, among others.

It is strongly recommended that further evaluation be conducted.
If thunderclap headache occurs again, please seek emergency medical attention.
If it does not recur, you may accompany your father to a neurology outpatient clinic for follow-up examination.
However, due to the recent increase in COVID-19 cases, please ensure to implement self-protection measures, including cleaning and disinfecting, and adhere to preventive health guidelines before and after seeking medical care.

Thank you for your inquiry, and feel free to discuss any related questions! Wishing you good health and safety.
Dr.
Jiang Junyi, Taoyuan Hospital.

Reply Date: 2022/04/05

More Info

Severe headaches, especially those that occur suddenly and are accompanied by other concerning symptoms, warrant careful consideration and often require medical attention. In the case you described, your father experienced a sudden, intense headache after standing up from a squatting position, which is a significant detail. This type of headache, particularly when it is described as "thunderclap" or "explosive," can be indicative of serious underlying conditions such as subarachnoid hemorrhage, cervical artery dissection, or other vascular issues.

The symptoms your father experienced—facial flushing, elevated blood pressure, and the sensation of pulsation in his head—are also noteworthy. The initial blood pressure reading of 143/83 mmHg is indeed higher than his usual levels, which could be a physiological response to pain or stress. The subsequent reading of 120/80 mmHg after resting suggests that the initial spike may have been transient and related to the acute episode of pain.

Given that this was a first-time occurrence for your father, it is crucial to approach this situation with caution. The combination of severe headache, changes in blood pressure, and other symptoms like visual disturbances and persistent hiccups could suggest a more serious condition that requires further evaluation.
In general, if someone experiences a sudden and severe headache, especially if it is unlike any headache they have had before, it is advisable to seek immediate medical attention. Emergency departments are equipped to perform necessary imaging studies, such as a CT scan or MRI, to rule out serious conditions like bleeding in the brain or other neurological issues.

Additionally, the fact that your father felt better after resting is a positive sign, but it does not eliminate the need for further evaluation. It is essential to ensure that there are no underlying issues that could lead to more severe complications in the future.
In summary, I strongly recommend that you take your father to a hospital for a thorough evaluation. This should include a neurological examination and possibly imaging studies to rule out any serious conditions. Early diagnosis and intervention can be critical in managing potential complications effectively. It's always better to err on the side of caution when it comes to sudden and severe headaches, especially in older adults.

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