top of page

VASCULAR HEADACHES & SECONDARY CAUSES

Vascular brain ALLOR Cosmetic Medicine

Vascular headaches are often triggered by changes in blood flow or pressure in the brain’s blood vessels.

 

Unlike migraine, they’re typically caused by identifiable structural or metabolic factors - such as blocked arteries, high blood pressure, or other conditions affecting blood circulation. Some of these headaches occur as a possible sign of a serious medical issue. Others are considered rare but benign.

​

This page covers several types of vascular and secondary headaches, including thunderclap headaches, cough and orgasmic headaches, and headaches related to postural changes, metabolic shifts, or cerebrovascular disease.

​

If you ever experience a sudden, severe headache that feels different from your usual pattern, or if your headache is joined by new weakness, changes in speech or vision, fever, or happens after a head injury, it’s important to take these symptoms seriously. Please don’t wait, seek urgent medical care, getting help quickly can make all the difference.

Cerebral Artery Occlusion & Related Headaches

Headaches caused by occlusion or narrowing of cerebral arteries (including stroke or transient ischemic attacks) are usually secondary to the vascular event.

These headaches may:

- Begin suddenly or gradually.
- Be accompanied by neurological symptoms such as weakness, speech difficulty, or visual changes.
- Vary in intensity but often feel dull or pressing.

 

In some cases, a headache may be the first symptom of a stroke. If a vascular event is suspected, urgent medical assessment is required.

​

“A sudden, severe headache with no known cause may be a warning sign of stroke.”
- American Stroke Association, “Stroke Symptoms

Post-Endarterectomy Headache

After a carotid endarterectomy (a procedure to remove plaque from the carotid artery), some people experience a headache in the weeks following surgery. This pain is usually mild and temporary, often on the same side as the operation. It may result from changes in blood flow or inflammation during healing. If a headache is severe, persistent, or comes with other symptoms, further medical review is important.

Source: Johns Hopkins Medicine - Carotid Endarterectomy

Postural Hypotension Headache

When blood pressure drops suddenly upon standing up, a condition called orthostatic or postural hypotension, some people can develop a dull, bilateral headache.

 

This type of headache often:

- Feels dull and affects both sides of the head

- Is most noticeable at the back of the head or neck

- Gets worse with standing and tends to ease when lying down

 

Underlying causes may include dehydration, medications, or problems with the autonomic nervous system.

Source: Mayo Clinic - Orthostatic Hypotension

Thunderclap Headache

A thunderclap headache is a sudden and extremely painful headache that reaches peak intensity in under a minute. It often feels explosive and unlike any previous headache.

 

Possible causes include (all of which are medical emergencies):

- Subarachnoid hemorrhage (bleeding around the brain) 

- Reversible cerebral vasoconstriction syndrome (temporary narrowing of brain arteries)
- Cerebral venous sinus thrombosis (a clot in the brain’s venous system) 
- Pituitary apoplexy (bleeding or lack of blood supply to the pituitary gland)


PLEASE NOTE: Because these causes can be life-threatening, urgent medical evaluation and imaging are essential even if the pain subsides quickly.

Source: StatPearls: Thunderclap Headache

Cough Headache

A primary cough headache is triggered by coughing, sneezing, straining, or laughing.

​

It typically:

Lasts seconds to minutes
- Is sharp, bilateral, or occipital
- Occurs in older adults (especially men)

​

If it's new, persistent, or accompanied by symptoms such as dizziness, vision changes, or fainting, further evaluation, which may include MRI is needed to rule out secondary causes like Chiari malformation.

Source: Mayo Clinic - Cough Headaches

​​

man coughing having a cough headach

Orgasmic Headache

Sometimes referred to as “coital cephalalgia,” this headache arises during sexual activity.

It may:

- Build gradually as a dull ache (Type I)
- Come on suddenly at the moment of orgasm (Type II, explosive)

 

Orgasmic headache should be investigated to exclude aneurysm, haemorrhage, brain tumour, or vascular malformations.

Source: International Headache Society (ICHD-3)

Headache from Metabolic or Toxic Triggers

Certain headaches arise from metabolic imbalance or exposure to toxins.

Examples include:

- Hypoxia or high altitude headaches
- Dehydration
- Carbon monoxide exposure

 

These headaches may vary in location and intensity but often resolve when the underlying cause is corrected.
 

Source: Mayo Clinic - Headache Causes

Why These Conditions Need Specialist Care

At ALLOR, we do not treat the vascular or secondary headache types listed on this page with Botulinum toxin or any other intervention. These types of headaches require individualised assessment and are best managed by your GP or a specialist neurologist.

​

If you're experiencing any of these symptoms, we strongly recommend dialing 111 for urgent medical attention.

​

You can also find helpful links on our migraine resources page for further information.

YOU MAY ALSO LIKE

Botulinum toxin injections are prescription only medicine for the treatment of frown lines, horizontal forehead lines, and crow’s feet round the eyes. Botulinum toxin injections have risks and benefits. Ask your doctor if botulinum toxin injections are right for you. If you have side effects, see your doctor. You will need to pay for your botulinum toxin injections and clinic fees will apply. For details on precautions and side effects consult your doctor or go to www.medsafe.govt.nz. Botulinum toxin injections last about 4 months and further courses of treatment may be necessary. Should only be administered by trained medical professionals.

bottom of page