Haunting Headaches

Types of Headaches

Headaches are often described as pain in the head above the eyes or ears or in the back of the head or upper neck regions. The headaches are such common occurrences that the International Headache Society has actually classified it as Primary (tension, migraine, and cluster types), Secondary and Cranial neuralgias (pain due to inflammation of the nerves of the head) and other headaches.

Primary headaches are not associated with other diseases and are not life-threatening, but may feel like symptoms of some serious complaints like stroke or intra-cerebral bleeding.

Secondary headaches are due to structural problems in the head or neck; due to brain tumors, meningitis, subarachnoid hemorrhage or stroke. These may very rarely precede a heart attack. Withdrawal of caffeine or analgesic meds can also cause these.

Tension Headaches

These are very common; may even be on a daily basis. A pressured tightness at the base of the head and neck, occurring both sides of the head, that are not associated with any nausea or vomiting or aura (seeing bright spots or lines of light). There may feel like a pressure on the eyebrows. Individuals will be able to function normally with this type of headache. This mainly results from physical or emotional stressors.

Treatment is mostly over-the-counter (OTC) meds like aspirin, ibuprofen, acetaminophen etc. While these are generally safe and successful, OTC meds can interact with other prescription drugs and can cause side effects. So, medical help is the best when headaches become chronic. The best option to try out first and foremost will be to find means of controlling the physical and emotional stressors that cause these headaches.

Migraine Headaches

These headaches are common and occur in adults as well as children. Women are thrice as much affected as men. Nearly 12% of US population suffers from migraine. Migraine usually runs in the family. These are vascular type of headaches where blood vessel enlargement and chemical release from nerve fibers are the cause. Migraines occur unilaterally as a throbbing or pounding pain anywhere from 2 to 72 hours duration accompanied by nausea, vomiting, light and/or sound sensitivity. Most of the times, it is preceded by aura where one may visualize flashing colorful zigzag lights or a blind spot. Migraines are predictable and individuals usually have some preceding symptoms like fatigue, depression, sleepiness, craving for some type of food, etc.

Treatment options will include basically avoidance of untimely food, limiting caffeine, exercising daily, avoiding trigger foods, maintaining a regular sleep cycle. Prophylactic meds in the form of calcium channel blocker, beta-blocker, antidepressants, and anticonvulsants do help. These also help reduce the occurrence of menstrual migraines to a great extent. However, a physician needs to take into account the possible drug-drug interactions while treating migraines.

Cluster Headaches

There are studies evident that these headaches result from the malfunction of the hypothalamus (the base of the brain). These come in clusters lasting for weeks or months. There may be a genetic reason also. They can last up to 1-1/2 hours and occur at the same time each day once or twice a day. One may be woken up from sleep. This usually causes a poking sensation of the eye, reddening and watering of the eye and nose. These may be triggered by some medicines like the nitroglycerin and also by cigarette, alcohol, chocolates etc. These may re-occur after several months or even a year.

These headaches do cause excruciating pain making the person restless and they may even bang their heads hard.

Treatment for this is very much patient-specific and generally it is very difficult to treat cluster headaches. Making the patient inhale oxygen at high concentrations may help at the initial stages of the headache. Tryptan meds, local anesthetics, caffeine all help in the treatment. Some times calcium channel blockers, antidepressants, anti-seizure meds, prednisone etc are used to prevent the occurrence of the next headache episode.

Diseases/Conditions Leading to Headaches

1. Trauma to head and/or neck

2. Vascular conditions like coronary artery disease, transient ischemic attack, stroke, as well as head and neck arteries getting inflamed.

3. Non-vascular conditions like seizures, tumors, or excess pressure of the cerebrospinal fluid.

4. Excess or inappropriate medications, side effects or withdrawal symptoms.

5. Viral and bacterial infections like meningitis, AIDS, pneumonia or other infections.

6. Body imbalances causing hypertension (high BP), sleep disorders, thyroid disorders, kidney dysfunction, allergies or dehydration.

7. Psychiatric disorders.

Therefore, proper evaluation of the headache with appropriate tests like MRI, CT, EEG and treatment of the cause will help alleviate most headaches.

Threatening Headaches

One-third of the sudden-onset severe headaches will represent a neurological condition that will necessitate rapid further evaluation since it becomes important to rule out for subarachnoid hemorrhage, vascular dissections, cerebral sinus thrombosis, intracranial hematomas, brain tumors, and other serious conditions. Any headache that does not subside with regular OTC meds needs to be evaluated further. When vomiting occurs in a non-migraine type headache, it is a concerning sign. Headaches worsening over months or weeks indicate some potential life-threatening underlying disease. Any abnormal neurological finding on exam during a headache is concerning. Onset of headache after age 55 and headache precipitated from bending, lifting or coughing is a concern. Headache waking up one from sleep is also a source of concern.

Know it from our informational video “Headache prevention tips ”.

Watch the Video: Headache Prevention Tips

Arab Proverb ...

"Every head has its own headache” ~ Arab proverb