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What to do if…
you have a new severe headache with a droopy eyelid or unequal pupils

Produced and maintained by PanicStation.org Published: Last reviewed: Editorial policy USA guide

Short answer

Call 911 now. A new severe headache with a droopy eyelid or noticeably unequal pupils needs emergency evaluation.

Do not do these things

  • Do not drive yourself to the ER if 911 is available; use an ambulance.
  • Do not wait to see if it improves, even if symptoms come and go.
  • Do not take aspirin, extra pain medicine, or someone else’s medicine unless 911 dispatch or a clinician tells you to.
  • Do not drink alcohol or use recreational drugs to blunt the pain.
  • Do not ignore sudden weakness, numbness, face drooping, speech trouble, confusion, trouble walking, or major vision change.

What to do now

  1. Call 911 and say: “I have a new severe headache with a droopy eyelid or unequal pupils.”
  2. Say when it started: give the time the headache began, the time you first noticed the eyelid or pupil change, and the last time you were definitely normal.
  3. Tell 911 about any stroke-like symptoms. Do not delay the call to check for these:
    • Face drooping
    • Arm weakness or numbness
    • Speech difficulty
    • Sudden vision change
    • Sudden trouble walking, dizziness, or loss of balance
  4. Get into a safer waiting position: sit or lie down somewhere responders can reach you easily. If you feel faint or vomit, lie on your side.
  5. Make entry easier if you can do it safely: unlock the door, turn on a light, and keep pets away from the entrance.
  6. Gather only essentials within reach: ID, insurance card if you have one, a medication list or medication bottles, allergies, and major medical conditions. Mention blood thinners or recent head, neck, or eye injury.
  7. Do not eat or drink unless 911 dispatch or a clinician tells you to. If you have essential prescribed medicine due now, tell dispatch or the responding clinicians before taking or skipping it.

What can wait

  • You do not need to decide whether this is a migraine, cluster headache, stroke, aneurysm, eye problem, or something else.
  • You do not need to call your primary care clinician before calling 911 for this symptom combination.
  • You do not need to pack a bag, search online, or arrange your own transport.

Important reassurance

Calling 911 for this is appropriate. Many headaches are not dangerous, but a new severe headache with a new droopy eyelid or unequal pupils is not something you should sort out alone or wait through.

Scope note

These are first steps only to reduce risk and get emergency assessment started. Later decisions about diagnosis, tests, treatment, or follow-up may need specialist medical help.

Important note

This is general information, not medical advice, a diagnosis, or professional medical care. If these symptoms are happening now, returning, or worsening, use 911 or emergency medical care.

Additional Resources

Closely connected guides that may be useful during the same situation or its immediate aftermath.

About this guide

This guide was produced and is maintained by PanicStation.org using its published editorial process. Official and specialist sources are checked where relevant, and AI-assisted tools may be used for drafting, organisation, and consistency checks. The site operator remains responsible for publication, revision, and removal decisions.

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