Causes of New-Onset Headache After 50

Many people who present with new-onset headache often think it's a migraine. About 12 percent of Americans experience migraines. Migraine attacks recur and are characterized by throbbing or pulsing pain, which usually affects only one side of the head. People experiencing migraines are sensitive to light and sound. They commonly experience nausea and vomiting, too.

Keep in mind, however, that migraines rarely begin anew in older people. In fact, migraines tend to improve with age.

Moreover, after 45, the new onset of cluster and tension headaches—the other two types of primary headache—is rare, too. That, of course, doesn't mean that new headaches after age 50 don't happen. It simply means that the chances of them being secondary to something else increases.

Secondary Causes

Many of the potential causes of new headache after age 50 are, unfortunately, serious. It's important to remember, though, that a symptom of something doesn't mean that you have that something.

Regardless, you are encouraged to see your physician if you're experiencing persisting or severe headaches. Your physician may explore more benign causes like intense stress or postural issues, but also some of these health concerns:

Intracranial hemorrhage: There are several types of brain hemorrhages or bleeds that are characterized by anatomy.

• Subdural hematomas
• Subarachnoid hemorrhage
• Epidural hematomas
• Intracerebral hemorrhage 

Older people are at increased risk for developing brain bleeds. Furthermore, sometimes these bleeds are triggered by an injury such as an accidental fall. Some types of brain bleed are slow and a person can retain consciousness for a while. In this period, for example, an elderly woman can maintain conversations, drive a car, or run a company.

Giant cell arteritis: Giant cell arteritis is a systemic or body-wide vasculitis that attacks the temporal artery (hence its alternative name, temporal arteritis). Vasculitis refers to inflammation of the blood vessels. Temporal arteritis is a medical emergency; if not treated in time, it can cause blindness. It usually affects white women over 50 and presents as a throbbing over the temples, scalp tenderness, and jaw fatigue with chewing.

Mass lesion: Older people are at higher risk for a brain tumor (i.e., brain cancer). The hydrocephalus from a growing tumor can compress the brain and brain system. This compression results in brain damage and death. More than 50% of individuals with high-grade gliomas experience headache. An MRI is needed to confirm the diagnosis.

Trigeminal neuralgia: The incidence of trigeminal neuralgia increases with age. Trigeminal neuralgia occurs when the small blood vessels of the face cross with the trigeminal nerve. The trigeminal nerve is the largest pair of cranial nerves, which innervates the front of the head. People with trigeminal neuralgia are left with trigger points that set off intense pain that can last anywhere from two seconds to two minutes. Trigeminal neuralgia is treated with anticonvulsants including carbamazepine, oxcarbazepine, topiramate, gabapentin, pregabalin, clonazepam, phenytoin, lamotrigine, and valproic acid.

A Word From Verywell

Listen to your body and inform your physician of how you're feeling early on. Again, your head pain may be cause for concern, but not necessarily alarm. On the other hand, if one of these issues is affecting you, learning about it sooner than later can not only be beneficial, but potentially life-saving. Making an appointment with your physician if you're concerned about a headache or any other problem is always a good idea. Your physician is there to help and guide you down the path of good health.