Ice Pick Headaches

What Is An Ice Pick Headache?

An ice pick headache is a type of headache which occurs when pressure is placed on the brain. Pressure is usually applied to the head or neck area. There are different types of icepick headaches, but they all have one thing in common: They occur after pressure is put on the brain.

Ice pick headaches are most commonly caused by pressure being applied to the ear drum during loud music or other sounds. Some cases may also occur if someone presses their finger against the side of your face while speaking loudly.

Other causes include:

Coughing up blood (hemorrhoids)

Having a cold (influenza) or the flu (the flu virus) causing swelling of the throat and sinuses. This can cause a tightness in the chest, pain in the back of your neck, nausea and vomiting, weakness or dizziness, shortness of breath and even seizures. These symptoms may not appear immediately after contracting influenza. You may only experience the headache later after all the symptoms are gone.

Getting hit in the back of your head, neck or ear

Drinking too much alcohol and then taking a nap

Ice pick headaches can also be caused by a much more dangerous condition known as an aneurysm. Aneurysms are weak spots on the wall of an artery. Arteries are the blood vessels that carry oxygen-rich blood all over your body.

The brain is supplied by the internal carotid arteries. The internal carotid artery branches off into another set of arteries known as the anterior cerebral arteries.

If you have an aneurysm in one or more of your anterior cerebral arteries, it can cause a seal to break and blood to seep through it. This may result in the artery to become swollen and inflamed (this is similar to what causes heart attacks).

The blood then may seep out of the artery and into surrounding brain tissue. This can cause a blood clot to begin forming. The blood clot then can prevent adequate blood flow to part of the brain. This is similar to what occurs during a stroke.

In some cases, a blood vessel may completely burst. A broken blood vessel in this area is extremely dangerous because it can cause bleeding into the brain (brain hemorrhage).

What Are The Different Types Of Icepick Headache?

There are several types of ice pick headaches, but they all start with the letter “I”. They are known as:

Idiopathic

Idiopathic thunderclap headache (or ICH) is a severe headache that comes on suddenly and reaches its peak within seconds or minutes. It then begins to gradually improve over the next few hours or days. Idiopathic simply means that the cause is unknown. It does not mean that the cause is related to any underlying condition, disease or disorder.

Intracranial Venous Thrombosis

Ice pick headaches caused by intracranial venous thrombosis are sudden and severe headaches that occur due to a blood clot in one of your blood vessels. A blood vessel is any tube through which your blood travels. A vein is one of the 4 types of blood vessels. It carries blood that is returning to your heart from your body.

Blood clots (thrombosis) can occur in a blood vessel and block it. A blood clot can also break away and travel through the bloodstream (becoming an embolism). An embolism is a solid substance ( clot or piece of fat ) that travels through the bloodstream. It is the major cause of heart attacks.

If a blood clot travels through your bloodstream and gets stuck in one of your brain’s blood vessels, you will have an ice pick headache. This type of ice pick headache is fairly rare. However, it is serious enough to cause death if it is not treated immediately.

It is typically caused by some form of trauma such as an injury or accident (such as falling or striking your head). It can also be caused by some types of migraine medications.

Smoking and pregnancy increases the risk of developing an intracranial venous thrombosis.

Subarachnoid hemorrhage (SAH)

If a blood vessel in your brain bursts, you can develop an intracerebral hemorrhage (ICH). This is a life-threatening brain bleed. It is typically preceded by a sudden, severe headache known as a thunderclap headache.

It typically causes a sudden and intense pain at the back of your head and neck. This pain quickly moves to the front of your head as the brain swelling begins. The pain is often accompanied by nausea, vomiting and blurred vision. Other symptoms may also occur such as feeling sleepy or tired, slurred speech and confusion.

These signs and symptoms are often the only warning you will get if a blood vessel in your brain bursts. These types of hemorrhages are often fatal.

These types of headaches can be classified into two categories:

SAH (subarachnoid hemorrhage) is the term used when a person has a brain bleed in the subarachnoid space (the area between the outer and middle layers of the brain).

ICH (intracerebral hemorrhage) is the term used when a person has a brain bleed into the brain tissue.

How Are They Diagnosed?

If you experience any of the symptoms of ice pick headaches, you should consult your doctor immediately. You need to let them know if you have suffered any head injuries recently or if you are using any migraine medication. Your doctor will ask you some questions and perform a physical examination.

Sources & references used in this article:

External hand warming as a novel treatment for ice pick headaches: a controlled case study by KL Hofstadter-Duke, KD Allen – Applied Psychophysiology and …, 2011 – Springer

Icepick‐like pain by NH Raskin, RK Schwartz – Neurology, 1980 – AAN Enterprises

Primary stabbing “ice-pick” headache by LO Mukharesh, MMS Jan – Pediatric neurology, 2011 – Elsevier