Headache and migraine: causes, red flags and which doctor to see
Almost everyone knows what a headache feels like: most often it is a tension headache or a migraine, and both can be managed. If your head hurts often, severely or in a new way, start with a neurologist — they will look into the causes and suggest a plan.
Common causes
- Tension headache — after long work, stress or lack of sleep
- Migraine — attacks of throbbing pain, often with nausea and light sensitivity
- Eye strain from screen work
- Poor sleep, too much caffeine, dehydration
- High or low blood pressure
When to seek urgent help
Do not wait for a scheduled visit if you have any of these signs:
- A sudden "thunderclap" headache — the worst of your life
- Headache with high fever and a stiff neck (you cannot bend your head to your chest)
- Headache after a head injury or a fall
- Headache with speech or vision problems, or weakness in an arm/leg — call 103
- A daily, gradually worsening morning headache with nausea
Ambulance: 103 (103 from a mobile) · Unified rescue service: 911
Your specialist
Neurologist
What to bring to the visit
- A headache diary for at least a week: when it hurts, for how long, what helps
- A list of medicines you take, including painkillers
- Results of previous tests, if any (MRI, CT, doctors' reports)
- Your blood pressure readings, if you have measured them
Frequently asked questions
What is a migraine and how is it different from an ordinary headache?
Migraine means recurring attacks of throbbing pain, more often on one side of the head, lasting from 4 hours to 3 days, typically with nausea or sensitivity to light and sound; physical activity makes the pain worse. A tension headache is usually a pressing, band-like pain on both sides that does not get worse with ordinary walking. A neurologist will tell them apart and suggest a plan: the diagnosis is based on your history and an examination, and not everyone needs an MRI.
Headache on one side of the head: what could it be?
One common cause is migraine. A rarer one is cluster headache: short, very severe attacks around one eye with a watery eye and a blocked nose on the same side, often at the same time of day. See a neurologist for either; for a sudden, worst-ever headache or pain with speech or vision problems or weakness in an arm/leg, call 103.
Migraine with aura or around your period: which doctor should I see?
Both are forms of migraine, and a neurologist deals with them. An aura means flashes, zigzag lines or a blind spot in your vision, less often numbness or tingling in a hand, that build up over several minutes and pass within an hour, usually before the pain; for migraine linked to your cycle, bring a headache diary that also marks your period days. An aura can look like the signs of a stroke, and you cannot tell them apart without a doctor: if the vision problem or numbness happens for the first time, differs from the attacks your neurologist already knows about, or comes with speech problems or weakness in an arm/leg, call 103 right away — do not wait to see whether it passes.
Can stress or “nerves” cause headaches?
Yes. Often it is a tension headache: a pressing, band-like pain on both sides that comes with stress, anxiety, poor sleep or long hours at a computer. Start with a neurologist; if anxiety and insomnia come along with the pain, a psychotherapist can help too.
Whom should I see if my headaches seem related to blood pressure?
Start with a general practitioner or a cardiologist — they will sort out the blood pressure. If your pressure is normal but the pain persists, see a neurologist.
Can I see a neurologist without a referral?
Yes, if you pay yourself: private clinics in Yerevan let you book directly. For the state health insurance to pay, you need a referral from the family doctor or therapist (general practitioner) you are registered with: without the required referral, the service is provided on a paid basis, except in emergency or urgent cases. You can also go without a referral for a chronic condition if your family doctor has already made the diagnosis.
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All symptomsThe information on this page is for reference only and does not replace a doctor's consultation. Only a doctor can make a diagnosis in person. If your condition worsens, call 103.