Why should you seek medical attention as soon as possible if you have a headache or vomiting?

Author: Chen Haibo, chief physician of Beijing Hospital

Reviewer: Hu Wenli, Chief Physician, Beijing Chaoyang Hospital, Capital Medical University

Headaches and vomiting often occur at the same time. Generally speaking, as long as the headache reaches a certain level, it can cause vomiting.

Many people have a history of vomiting, but we know that most of them are gastrointestinal reactions caused by infection and fever.

If the patient has no clear history of infection and no fever, but has a headache or vomiting for no apparent reason, he or she should seek medical attention immediately. If the symptoms persist for a week, two weeks, or even a month or two, there is no time to delay.

The doctor will make a preliminary judgment based on the nature of the patient's headache and vomiting, as well as accompanying symptoms, medical history, etc., and then conduct appropriate examinations to confirm the diagnosis so that correct treatment can be given as soon as possible.

1. Vomiting like spraying water and having a headache, what disease is most likely to be?

If it is not dry heaving, or ordinary nausea or vomiting, but instead something suddenly spurts out of the throat for no apparent reason, this type of vomiting is called projectile vomiting, which is more common in intracranial lesions, so you should get checked as soon as possible.

Projectile vomiting accompanied by headaches should be considered as increased intracranial pressure. Of course, there are many reasons for increased intracranial pressure, such as cerebral hemorrhage. Some people suddenly have cerebral hemorrhage, headaches, and vomiting. This situation is life-threatening and must be rushed to the hospital for treatment as soon as possible. Of course, there are also relatively slow diseases, such as intracranial tumors. As the tumor grows slowly, the intracranial pressure will increase.

Figure 1 Original copyright image, no permission to reprint

We know that the brain is surrounded by bones, and the space inside is limited. The brain tissue is inside, and there is some space for fluid. When the tumor grows, it will inevitably occupy the space inside the skull, and the brain tissue will be compressed. As the tumor grows bigger, the skull cannot hold so much, and the pressure will naturally increase.

In addition, encephalitis, cerebral venous sinus thrombosis, and the so-called obstructive hydrocephalus, which are caused by blockage of the outflow of cerebrospinal fluid due to various reasons, can all cause increased intracranial pressure.

When the intracranial pressure increases, in addition to causing headaches, it will also compress or stimulate the vomiting center, causing vomiting. So if this happens, go to the hospital as soon as possible.

2. Vomiting, headache, fever, and stiff neck, what could be going on?

In this case, meningitis should be considered. Simple meningitis is mostly caused by bacterial infection. If meningitis and encephalitis occur at the same time, it is often caused by viral infection.

When meningitis occurs, it irritates the brain and causes increased intracranial pressure, which can also cause vomiting and headaches.

In addition, because it affects the meninges, the meninges are not only in the brain, but also in our spinal cord, which runs from the neck to the lumbar sacral region. When the meninges are stimulated, as long as they are pulled, they will feel pain. So when you lower your head, the meninges will be pulled, which will stimulate the pain nerves of the meninges and cause pain.

So we say that when meningitis occurs, the patient cannot lower his head, and will feel pain if he lowers his head. At the same time, he cannot raise his legs high, because raising his legs will also pull the meninges and feel pain.

Therefore, vomiting, headache, fever, and stiff neck are often important signs of meningitis.

3. Vomiting, headache, and limited limb movement on one side. What could be going on?

If you suddenly experience headaches, vomiting, and stiffness on one side of your limbs, it indicates focal neurological dysfunction, suggesting that there is a lesion in the brain, but the nature of the lesion tends to be cerebral hemorrhage.

Because if there is cerebral hemorrhage, the amount of bleeding is often large. On the one hand, the blood can flow into the subarachnoid space, and the entire subarachnoid space will be filled with blood, which will stimulate the vomiting center of the medulla oblongata and cause vomiting. At the same time, the blood itself can easily cause a significant increase in intracranial pressure, thereby causing vomiting. Of course, if the amount of bleeding is particularly small, there may be no symptoms.

Cerebral infarction can also cause weakness and inflexibility of one side of the limbs, which is the same as the symptoms of cerebral hemorrhage. If the lesion is in the same location and size, numbness and weakness of one side of the limbs may occur.

But generally speaking, if the infarction area is not particularly large, a small or medium-sized infarction will not cause a significant increase in intracranial pressure. This situation generally does not cause vomiting unless the infarction area is particularly large.

Figure 2 Original copyright image, no permission to reprint

So from a chance point of view, if vomiting occurs, the possibility of cerebral hemorrhage is the greatest. The examination is also relatively simple. A CT scan at the hospital can immediately distinguish it.