What causes persistent headache?

Persistent headache may be caused by migraine, tension, medication effects, infection, vision problems, or a neurological condition. A new or changing headache can sometimes occur with a brain tumour or brain metastases, but headache alone cannot establish that diagnosis.

The location, pressure or throbbing quality, timing, triggers, and associated symptoms help guide assessment. Headache that is worse in the morning, changes with coughing or straining, or comes with vomiting, visual changes, weakness, seizures, personality change, or balance problems needs particular attention. Conditions such as glioblastoma, meningioma, and pituitary tumour can present with headache, although many headaches have non-cancer causes. A clinician may examine your nerves, vision, blood pressure, and medicines, then decide whether imaging or other tests are needed.

Book a medical review for a headache that is new, persistent, recurrent, or interfering with normal activities. Record when it starts, how long it lasts, its severity, possible triggers, medicines taken, and symptoms such as nausea or visual disturbance. Avoid repeatedly increasing pain medicine without advice, since frequent use can sustain headaches. If you have a known cancer diagnosis, tell your oncology team about a new pattern or any neurological change.

Seek emergency care for a sudden severe headache, headache after a significant injury, or headache with weakness, trouble speaking, seizure, fainting, confusion, fever with a stiff neck, or sudden loss of vision. New neurological symptoms need urgent assessment even if the pain later eases.

Does this pattern suggest migraine, medication-related headache, or another cause? Do I need a neurological examination, eye assessment, or brain imaging? Which pain medicines are suitable, and how often may I take them?