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Headaches: When Should You Worry?

Almost everyone gets a headache once in a while, and some unlucky people have them almost every day. Usually we pay little attention to them-we take a couple of Tylenol, and in a few hours the headache is gone. But sometimes headaches become so painful or so frequent that we start to worry: could it be the symptom of a brain tumor or the warning sign of an oncoming stroke?

By Richard Lappin, MD, PhD
New York Presbyterian Hospital - Weill Cornell Medical College

Almost everyone gets a headache once in a while, and some unlucky people have them almost every day. Usually we pay little attention to them-we take a couple of Tylenol, and in a few hours the headache is gone. But sometimes headaches become so painful or so frequent that we start to worry: could it be the symptom of a brain tumor or the warning sign of an oncoming stroke?

The good news about headaches is that the vast majority of headaches are completely harmless. However, every once in a while a headache is a warning of some serious-or even deadly-condition. So how do you tell?

Old Versus New Headaches
There's an old joke in which a worried patient asks, "Doc, what have I got?"
"Have you had it before?" the doctor asks.
"Yes," the patient replies.
"Well," the doctor announces, "you've got it again."
There's an important lesson in this joke; sometimes the most important fact about your symptom is whether it's happened to you before. This is especially true with headaches.

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