Why does meningitis cause headache?

The brain itself does not feel pain in the same way as skin or muscle, but its protective membranes and blood vessels are pain-sensitive. In meningitis, those membranes become inflamed. This may create a severe, persistent headache and make movement or bright light uncomfortable. Headache is a common presentation of Meningitis. It can occur with fever, neck stiffness, vomiting, sleepiness, confusion, or a rash, although symptoms do not always arrive together. A headache has many causes, so it does not by itself identify meningitis.

Treat a new severe headache with fever or neurological symptoms as urgent. Seek medical help rather than relying on pain relief to monitor the situation. While arranging care, keep the person in a calm environment and do not leave someone alone if they are confused, unusually sleepy, or getting worse. Note the onset of symptoms and any recent infection, but do not wait for a particular symptom combination before obtaining assessment.

Call for emergency care immediately if headache occurs with fever and a stiff neck, altered behaviour, confusion, difficulty waking, seizure, repeated vomiting, new weakness, trouble speaking, or a rash that does not fade with pressure. Sudden, extremely severe headache also needs emergency assessment. In infants and children, poor feeding, persistent crying, unusual floppiness, or marked irritability can be important warning signs.

Ask which features of the headache and examination findings are most concerning, what tests are needed, and whether treatment needs to begin before results are back. Ask what changes in alertness, rash, breathing, or pain should be reported immediately.