Find out how likely a sudden severe headache might be a TIA: transient ischemic attack.

If you get a sudden severe headache, you might wonder if this might be a transient ischemic attack (TIA).

A TIA is a mini stroke, and stroke medicine falls under the specialty of neurology, since strokes involve the brain.

“Perhaps the only reassuring measure to afford a patient some mental relief is to know that headache, especially when severe, is not routinely a symptom of a transient ischemic attack (TIA),” explains Michael Sellman, MD, neurology division chief with the Greater Baltimore Medical Center’s Center for Neurology.

“TIA in layman’s terms connotes the brief absence of blood flow to the brain,” continues Dr. Sellman.

“So for example, if there is not enough blood to our motor cortex or speech centers, a patient would then have symptoms of loss of strength or loss of speech.”

Other symptoms of a transient ischemic attack, that are far more likely than a headache, are sudden onset double vision or other visual disturbance, confusion or cognitive impairment, slurred speech, dizziness, and one or more of the following on one side (or both sides) of the body: paralysis, numbness, heaviness, clumsiness.

Dr. Sellman emphasizes that a headache, especially a severe one, “is not routinely a symptom of absence of blood flow to the brain or impending stroke.  There are many other causes of severe headache, but TIA is not one of them.”

Some more likely causes of a sudden severe headache: migraine, ruptured aneurysm, pinched nerve in the neck, “icepick” headache (though these last only moments).

Some likely causes of a less sudden-onset but severe headache: migraine, tension/stress, sinusitis, pinched nerve in the neck, bleeding in the brain from a head injury, brain cancer or benign tumor.

“In general a patient should be advised to call or see a doctor if the severe headache is of new onset or never experienced before. 

Severe headache of new onset should not be ignored, but is not due to TIA.”

Dr. Sellman’s interests are in clinical neurophysiology and neuromuscular disorders. He previously served as chief of the Division of Neurology at Mercy Medical Center since 2002.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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