The majority of headaches are harmless. Credit:

While headaches are very common, there are some instances when they indicate a serious underlying problem.

IT was just a regular day for Michael Lim when he got into his car one evening and instructed his driver to take him home.

The 47-year-old successful businessman had just attended a dinner gathering with friends and work associates and was looking forward to relaxing at home for the rest of the night.

Halfway through the drive home, he experienced a sudden and extremely severe headache.

It was the worst pain he had ever encountered and he immediately instructed his driver to take him to the nearest hospital.

They made it just in time because upon reaching the hospital, Lim collapsed and lost consciousness.

A CT scan showed bleeding in his brain. Subsequently, an angiogram was performed which revealed that Lim had suffered a brain aneurysm.

His family members were informed that Lim would require immediate surgery to treat the condition.

Lim was already in a coma by then. Once his wife gave consent, he was wheeled in for surgery.

In a split second, Lim had gone from being a man with no major health issues to one experiencing a life-threatening condition.

Fortunately for Lim, he recovered from the surgery. One week later, he left the hospital. Eventually, he went back to living life as he had always done and resumed all his normal duties.

The one thing that saved his life was his decision to seek immediate medical attention when he experienced that sudden and severe headache.

If he had continued the drive home, he probably would not have made it.

Not all headaches are harmless. Credit:


Headaches can be classified as primary or secondary. While primary headaches (which account for 90 per cent of all cases) are harmless, secondary ones are more serious and they normally have an underlying cause, says Datuk Dr Kantha Rasalingam, consultant neurosurgeon at the Department of Neurosurgery, Kuala Lumpur General Hospital.

It is for this reason that one should never dismiss all headaches as harmless or common.

In some cases, they may be an indication of high blood pressure, a brain tumour or, as in the case of Lim, a brain aneurysm — all of which are life-threatening.

Dr Kantha says about 2-3 per cent of Malaysians are at risk of a brain aneurysm. The condition is usually precipitated by what is called a “thunderclap headache”.

The condition generally affects those between the ages of 30 and 60 but is most common in the 50-60 age group.

In almost 50 per cent of cases, patients do not survive. Getting the condition identified and treated immediately provides the best chance for recovery.

Dr Kantha explains that it is common for people to brush aside headaches as a normal occurrence because 65-77 per cent of all people have a headache at some point in their lives.

About 50 per cent also have headaches every year.

It’s also important to note that most headaches are not dangerous.

Headaches can be caused by various factors.

If you get a sudden and very severe headache, that is a red flag that should not be ignored.

Other dangerous signs include headache associated with symptoms such as vomiting, high extreme fever, seizures, rashes or headache associated with body or limb weakness or double vision.

These are all warning signs that require immediate medical attention.

 When you have any of the red flags mentioned above or when the headaches are becoming too frequent, say, four to five times a month or last more than 24 to 48 hours or when the severity become unbearable, seek medical attention immediately,” says Dr Kantha.

The first step is to talk to your doctor about your headache. The doctor will also give you a physical exam and ask about the symptoms and how often they happen.

It is very important to be as detailed and descriptive as possible in your answers.

Most people do not need special diagnostic tests but sometimes a doctor may suggest a CT scan or MRI to look for problems inside the brain that may be causing the headaches.

Dr Kantha says headaches related to high blood pressure are very common in adults above the age of 40 so they need to be cautious.

“When your blood pressure is very high and you’re also known to be hypertensive, you can develop a headache. This can be very dangerous because if you do not control blood pressure, you can have a stroke.”

Dr Kantha says headaches related to high blood pressure are very common in adults above the age of 40.


if the headache becomes progressively worse, a brain tumour may be suspected. The duration and intensity will get worse. It will normally be associated with other symptoms such as vomiting, visual disturbances, a weakness in an arm or leg, speech problems, personality changes or seizures.

The headaches may also be present at the beginning of the day unlike most other types of headaches.

The frequency of the headache generally progresses over time, starting with, for example, once a week and increasing to three or four times a week. The pain intensity also increases.

Dr Kantha says one 60-year-old patient suffered from headaches for almost six months but he just took pain killers to manage the condition.

He was eventually brought to the hospital after suffering a seizure and collapsing. Tests revealed that he had a malignant brain tumour. The patient underwent surgery but sadly, passed away a year later.

“The most important factor is the progression of the illness. When patients get symptoms such as blurring of vision, it’s already very serious. Of course, we routinely rule out eyesight-related issues when patients come to us with headaches.”

Headaches and vision problems may in many cases be due to eyesight-related issues but once these have been checked and ruled out, patients must seek medical attention if symptoms persist.



These are very common and can be described as a dull, aching sensation all over your head which is normally not throbbing in nature. There may also be tenderness or sensitivity around the neck, forehead, scalp or shoulder muscles.

As the name implies, it’s most often triggered by stress and common among adults and teenagers.

Tension headaches may result from work stress and deadlines. Credit:


An intense pulsing feeling from deep within your head which is normally throbbing and one-sided in nature. It significantly limits your ability to carry out normal duties.

People with migraine are sensitive to light and sound. Nausea and vomiting can also occur. Symptoms last for a few days. Women are three times more likely to develop migraine than men.

Sometimes, patients experience visual disturbances or a tingling sensation over the face prior to a migraine.

Episodes of migraine can happen three or four times a month and a person can suffer from this condition for years.


A deep and constant pain in your cheekbones, forehead or bridge of the nose. It happens when cavities in the head called sinuses get inflamed.

The pain usually comes along with other symptoms such as a runny nose, a feeling of fullness in the ears, fever and swelling in the face.


Women can get headaches from changing hormone levels during their menses. The drop in estrogen just before a woman’s menses may contribute to this headache.

Other hormone-related headaches are linked to pregnancy and menopause. The hormone changes from birth control pills can also trigger headaches in some women.



MAKING simple changes in our daily life can ensure that we become less prone to headaches.

These changes include:

* Avoidance of certain foods – alcohol, chocolate and aged cheese are common triggers for headache in some people. Understand what your diet triggers are and avoid those foods.

Coffee and chocolates can trigger headaches in some people. Credit:

* Proper sleep patterns – lack or excess sleep can cause headaches. Sleep makes you relaxed but do ensure that you have enough and not too much. 

* How we sleep — if you use a pillow that’s too soft or too hard, it will cause pain in your neck and result in a headache.

Too much or too little sleep can trigger headaches. Credit:

* Posture — our sitting posture (which these days is mostly governed by the use of mobile phones) means we bend our necks all the time, causing strain to the neck muscles and leading to headaches.

Posture resulting from smartphone use can result in neck strain and headaches. Credit:

* Exercise — it can help to reduce headaches so work out regularly.

Exercise is also beneficial in reducing headaches. Credit:

* Smoking — this can be a trigger factor for headaches so it’s best to avoid the habit.

* Diet — eating a balanced diet with fruit and vegetables is beneficial. On the other hand, skipping meals can make you hungry which can cause headaches. 


More than 80 per cent of Malaysians do not consume sufficient vegetables and fruits essential for a healthy diet. Health Minister Datuk Seri Dr. S. Subramaniam said the trend showed an unhealthy and worrying dietary style. (File pix)


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