What should you know about persistent headache and fatigue?

Headache and fatigue may follow infection, dehydration, disrupted sleep, migraine, anaemia, medication effects or prolonged stress. The combination can also occur with conditions affecting the brain, but symptoms alone cannot identify a cause. Brain tumours can present with headache and fatigue, while brain metastases and glioblastoma may cause these symptoms along with vomiting, seizures, altered thinking, balance problems, vision changes or weakness.

Describe whether the headache is new or different, whether it is worse on waking or with coughing, and whether fatigue improves with sleep. Mention fever, weight change, medicines, cancer history and any change in speech, movement, sensation or behaviour.

Arrange a clinical review if the symptoms persist, recur or reduce your ability to work, eat, walk or care for yourself. Keep a daily record of headache timing, severity, sleep, fluids, meals, medicines and associated symptoms. Rest in a quiet space, drink normally and avoid taking pain medicines more often than directed. A clinician can check vital signs, perform a neurological examination and decide whether blood tests or imaging are appropriate.

Seek emergency care for a sudden severe headache, seizure, collapse, confusion, new weakness or numbness, difficulty speaking, new vision loss, repeated vomiting or fever with a stiff neck. Contact an oncology team promptly if you have cancer and develop a new or steadily worsening headache, unusual sleepiness or a clear change in balance or behaviour.

Ask which causes need to be excluded, whether your medicines or blood count could contribute, whether neurological testing or imaging is needed, and how to manage fatigue safely. Ask which specific changes should prompt same-day advice.