Sharp pain on the side of your head, above your ear, might make you wonder about the whys and wherefores. It could be what's known as a temporal headache, meaning a headache on the side of your head at the temple. Or it could be something more serious.
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"Whether on the left or right side, a one-sided temporal headache suggests just a few possible conditions," says Zubair Ahmed, MD, a neurologist and headache specialist at the Cleveland Clinic's Center for Neuro-Restoration.
"To make a diagnosis of a one-sided headache, you need to consider the patient's sex and age, as well as other symptoms like vision changes, when the headache comes, how long it lasts and what might trigger it," says Deepa Iyengar, MD, a professor of family and community medicine with McGovern Medical School at UTHealth in Houston.
Two likely causes of sharp pain on the side of your head that comes and goes are migraines and temporal arteritis, both doctors say.
About Migraine Headaches
A migraine headache can cause severe pain that usually occurs on one side of the head, according to the Mayo Clinic. Migraines usually start at an early age, peak during the person's 30s and then ease up after that. They're three times more common in women than men. Keys to diagnosing this one-sided head pain include:
- A headache warning, called a prodrome, that may include mood changes or food cravings one or two days before an attack.
- Visual changes that occur before or during an attack, such as flashes of light or bright spots.
- Pain that lasts from four to 72 hours without treatment.
- Pain that is described as pulsing or throbbing.
- Pain that gets worse with light or noise.
- Nausea and vomiting along with the pain.
Read more: How to Get Rid of Visual Migraines
Temporal Arteritis Headache Pain
Temporal arteritis can affect any medium or large artery in the body, but it usually affects vessels in the temples, says Mayo Clinic. It usually affects both temples, Mayo adds.
Though less common, it can be a possible cause of headache pain in the left temple. "A severe one-sided temporal headache in someone over age 60 is more likely to be temporal arteritis," says Dr. Ahmed. "This type of pain is caused by inflammation of blood vessels. You may have a tender and swollen blood vessel in your temple area."
Dr. Iyengar adds that, "in addition to being a cause of a severe one-sided temporal pain, this condition can cause blindness in the eye on the side of the pain due to involvement of blood vessels that supply the eye."
Temporal arteritis, also called giant cell arteritis, almost always occurs in people older than 50, according to the Johns Hopkins Vasculitis Center. The average age for a first attack is 72. Like migraine, women are affected more often than men, being twice as likely to have temporal arteritis. Other symptoms may include:
- Pain in the hips and shoulders.
- Blurred vision.
- Pain in the jaw after chewing.
When to Call Your Doctor
If you think you might be having migraines, keep track of your symptoms and see your doctor for a migraine evaluation, suggests the Mayo Clinic. Your doctor may be able to diagnose your migraine based on your symptoms, and treatment should be available to reduce the pain and duration of a migraine attack as well as to prevent future attacks.
If you have any signs or symptoms of temporal arteritis, contact your doctor right away. This is important because a serious complication of this condition can be blindness, warns the Johns Hopkins Vasculitis Center.
Temporal arteritis can be diagnosed by the symptoms and by blood tests that show high levels of inflammation. A piece of a temporal blood vessel may be removed (biopsied) to look for evidence of inflammation. This condition requires treatment with steroids to block or reduce inflammation in blood vessels and to prevent vision loss, says Mayo Clinic.
For any type of headache, especially if it's a new pain or a severe pain, you also might need to have an MRI scan, or some other type of imaging test, to help find the cause, says the American Migraine Foundation.
A Third, and Serious, Possibility
"Finally, a rare but important cause of severe one-sided head pain is an aneurysm," Dr. Iyengar says. "This is a swelling of a blood vessel in your brain that may burst and cause a stroke."
"If you have a one-sided headache that is the worst headache you have ever had, you should get medical attention right away," she advises.
Is This an Emergency?
- Zubair Ahmed, MD, neurologist and headache specialist, Cleveland Clinic Center for Neuro-Restoration, Cleveland
- Deepa Iyengar, MD, professor of family and community medicine, McGovern Medical School, UTHealth, Houston
- Mayo Clinic: "Migraine"
- Johns Hopkins Vasculitis Center: "Giant Cell Arteritis"
- Mayo Clinic: "Giant Cell Arteritis"
- Mayo Clinic: "Giant Cell Arteritis - Diagnosis and Treatment"
- American Migraine Foundation: "Do I Need an Imaging Study For My Headache?"