How do you know when a headache is bad enough to go to the hospital?

If I were in your situation, I would be calling my Doctors who are familiar with my current medical problems and past history. They will ask you questions about other symptoms you might be having which can help guide their recommendations. At the very least, I’d call the walk-in clinic and tell them that the Imitrex hasn’t helped and ask them what to do.

If you are having any dizziness, confusion, numbness, lack of coordination, or changes in vision, hearing, or speech, call 911 or your emergency medical services # if you are outside of the USA.

Nausea, blurred vision? Then go over to the hospital for a check up.

Is it allergies? Sinus? It’s that time of year…
Personally I find ibuprofen and aspirin much more effective for that kind of thing.
Also, I presume you are not dehydrated. Oddly I’ve never had a doctor ask about simple things like that before leaping to explore more serious possibilities.

I hope you find relief soon.
With your history you must have doctors who are familiar with your conditions, I think @hearkat‘s suggestion to check in with them is the best idea.

Go NOW.

If it’s that bad, I’d go to the hospital. The worst that will happen is they’ll say it’s a migraine take xxx.

Does one side meaning side of your face? Or, literally side of your head? Side of head I would go directly to the hospital. One side of your face I might go through the motions of calling my doctor first, since he knows your history maybe he will order the Ct scan for you today and you can go directly to the diagnostic center. But, honestly, since you have no history of headache, I would go to the hospital. They need to do a CT scan and God forbid this turns into a real emergency you will already be there.

I’d go to the ER and get checked out, just to be safe. And I hope you comeback to update us on things.

I’ve had migraines. Pain like the worst of hangovers with constant nausea. My magic cure was Migraleve pink which worked wonders. If I were you though I would go to your doctor or the A & E of your local hospital to check it out for your peace of mind. The only reason I went straight to the pharmacist is because migraines run in my family and that can be a clue.
Take care of yourself.

Thanks for the responses. It went on for hours and hours after I posted this question, and then I drank a coffee and it vanished within 15 minutes. It has come back since but not nearly as bad. I am going to see a doctor in the next few weeks (for other reasons) but I think I’ll definitely mention this just to be safe.

Caffeine usually doesn’t work that quickly, but I am really glad it did for you. Were you in caffeine withdrawal? If you usually drink caffeine daily, you have to get your fix or you will get a bad headache. I didn’t mention caffeine since your headache was on one side.

No… that’s what I thought was weird. I don’t drink coffee… ever. I’m actually quite careful about caffeine intake. No coffee or tea, I’m allergic to chocolate, and a pepsi maybe once or twice a week..

Had you had a lot of Pepsi the day before the headache started?

The problem with treating a headache with caffeine is you can wind up with a bounceback headache when you begin to withdraw again. Hopefully, that won’t happen.

Glad to hear you’re feeling better! You should definitely mention this to your doctor.

Was it a Diet Pepsi? If so, consider it might be the Nutrasweet. That stuff is nasty, and converts to formaldehyde in the body.

We don’t know if the OP drank a Pepsi before the headache.