One-sided headache… can be life-threatening
Many people mistake it for stress, but there are signs that require immediate medical attention—learn about common causes, how to recognize dangerous symptoms, and basic care.
What is a unilateral headache?
A prominent, “one-sided” headache can be either a benign condition (e.g., migraine) or a condition that requires immediate medical attention (e.g., cerebral vascular disease, inflammation of the temporal artery, etc.). Differentiation by accompanying symptoms and history is important.
If symptoms are significantly different from before, are severe or acute, or if neurological symptoms occur, you should go to the hospital immediately.
Common causes
Migraine
- Throbbing pain on one side/alternating sides
- Photophobia/noise, nausea
- Aura may occur before pain.
Cluster Header
- Severe pain around one eye
- Watery eyes, stuffy nose, unilateral drooping eyelid
- It is intermittent (cluster)
Neck/posture pain
- Neck and shoulder muscles are tight and painful when pressed.
- Working/computer screen relationship
Danger Signs—Seek immediate medical attention
- First/most severe acute pain (“ฟ้าผ่า”)
- Weakness, numbness, slurred speech, double vision
- Fever, stiff neck, rash, or after a head injury
- Over 50 years old, first pain onset
- The pain continues to get worse or the original medication is no longer effective.
If any of these apply, don't wait—go to the hospital for immediate evaluation.
How to diagnose?
The doctor will take a history of the symptoms, their duration, and triggers, perform a neurological examination, and consider further investigations (e.g., blood work, CT/MRI) when there are signs of danger or a specific disease is suspected.
Migraine-like symptoms
- Throbbing pain for 4–72 hours, one side/alternating sides
- Nausea, photophobia
- Activities make it worse
Brain imaging must be considered.
- A new type of acute severe pain
- joint neurological symptoms
- Back pain from an accident or suspected infection
When did you see the doctor?
- Pain that is more frequent, more severe, or resistant to medication
- Have a chronic disease/are pregnant
- Old age and first onset of pain
Take care of yourself first.
- Rest in a dark, quiet room with reduced stimulation.
- Drink enough water, eat on time, and don't skip meals.
- Get enough and consistent sleep
- Use pain relievers as directed/as directed by your doctor, but do not use them too often.