I had the worst headache of my life righ

Treat this as an emergency, not as a migraine trigger: call your local emergency number now, or have someone take you to the nearest emergency department now, and tell me which country or city you are in so I can point you to the right line.

I cannot diagnose this and nothing here replaces a clinician. What follows is safe waiting-and-travelling care plus what to say when you arrive — it is not a home treatment.

Why this is not handled as "just my migraine"

• Having migraines does not make a sudden worst-ever headache safe to watch at home. People who get migraines can still have the causes that need emergency care.
• A headache that reaches full force within seconds is the classic pattern of bleeding into the space around the brain. Severe damage there can become irreversible within minutes to a few hours, which is why the clock matters more than anything else tonight.
• Sex and exertion are recognised triggers for that pattern. A headache that is new, or the worst you have ever had, is treated as a secondary cause until a clinician says otherwise.
• The neck is usually not stiff at the start. A supple neck is not reassurance, so do not wait for one before getting help.
• Even if the pain eases, the assessment still has to happen. Feeling better is not the test.

What usually gets tried at home, and what to do instead

Do not

• Take aspirin for this headache, or any new or extra headache tablet, including a triptan.
• Take anyone else's prescription, including painkillers, blood-pressure tablets or steroids.
• Start, stop, double or change any medicine you already take. Those are clinician decisions.
• Drive yourself. Get driven or let an ambulance come.
• Stay alone, and do not let anyone leave you alone overnight.
• Put anything in the mouth of a person who is drowsy, confused or not fully awake.
• Decide that it is safe because the pain went down, or because it feels like your usual migraine.

Red flags — if any of these is true, stay on the emergency line and say so

• The pain peaked within seconds or near-instantly.
• Fainting, drowsiness, confusion, restlessness, or speech that does not make sense.
• Weakness or numbness on one side, a drooping face, new vision loss, double vision, or an aura unlike your usual one.
• A fit.
• Fever with drowsiness, a stiff neck, or a rash that does not fade when pressed.
• Vomiting that keeps going, or vomiting with confusion.
• Pregnancy, or within the first days after birth, or a severe headache with blurred or flashing vision.
• A blow to the head, or blood thinners, or a house fire or poorly ventilated heaters.
• A new headache after age fifty with jaw pain when chewing, a tender temple, or a flicker of vision going.
• A red painful eye with rainbow rings around the lights.

Decision tree

• Right now → emergency call made, or being driven to a department, with someone staying beside them.
• Any red flag above appears → repeat the emergency call, or return to the department immediately, and do not wait until morning.
• Sent home after being seen → follow the return instructions exactly, keep the written list they give you, and do not restart anything that was stopped without asking. Someone stays with them that night.

While waiting or travelling — the only home-side steps that are safe

• Lie in a dim, quiet room. Lights low, noise down.
• Have one person stay with you and stay close. If you have the elder or a sibling nearby, that is their job for the next few hours.
• Small sips of water if you are fully awake and swallowing normally, and keep to your usual meals. Nothing by mouth if you are drowsy or confused.
• Have someone write down the facts below while they are fresh, or photograph this list and hand the phone over.
• Call for help rather than driving. Note the exact time things happened.

Facts to write down now, and to say to the crew

• The exact time it started, and whether it peaked within seconds or built up over minutes or hours.
• What you were doing at that moment.
• The time you were last seen well, and any earlier episode that settled on its own.
• Whether it is the worst you have ever had, or like your usual attacks. One-sided or whole head. Throbbing or tight band. Worse with coughing, bending, light, sound, or chewing.
• Fever, rash, vomiting, stiff neck, weakness, numbness, speech change, vision change, double vision, whooshing in the ears, any fit.
• Pregnancy or recent birth, a head injury, heaters or a fire, cancer or immune suppression, blood thinners.
• Every medicine in the house, the directions written on each box, and what you actually took and when. How often you use painkillers in a month — that is a fact for the clinician, not a quota to judge yourself against.
• Family history of migraine.

Bring the medicine boxes themselves, not a list from memory.

Worth asking the clinician: what specifically should bring us back, over what time this should improve, could this still be a bleed or another emergency cause, and what must we not do at home.

Scripts for the caregiver, for the school week

To whoever stays with them, and to whoever drives:

> "Call the local emergency number now and stay on the line while they describe what happened. Do not drive them yourself. Stay in a dim room with them, and keep the medicine boxes packed in one bag."

To the dispatcher:

> "Adult with a history of migraine. Sudden worst-ever headache, started right after sex at [time]. It peaked [within seconds / over several minutes]. [No / yes] loss of consciousness, weakness, speech change, vision change, fit, fever, vomiting, stiff neck."

To the school or the child's teacher, and to family:

> "I am at hospital with [name], so [child] will be [collected by name / not going in today]. I will send a message as soon as I know more."

Keep it to what is true. Do not promise a time of return or a result.

What a good next twenty-four hours looks like

• The emergency call is made, or you arrive at a department today. That is the goal for today.
• A clinician assesses you and decides whether imaging or other tests are needed. That decision is theirs.
• You leave knowing the return signs in writing and who to call, and what must not be done at home.
• Someone is beside you tonight. Nobody watches this alone overnight.

Pain being gone at home is not the success measure. Being seen, and knowing the plan, is.

Coverage gaps, stated as gaps: any dose, amount, or timing for any medicine is deliberately not on this page — that comes from a clinician, or from the label your prescriber wrote. No emergency number is printed here because none could be verified for a place you named; tell me your country or city and I will look it up.

Source: merck-pro https://www.merckmanuals.com/professional/neurologic-disorders/stroke/subarachnoid-hemorrhage