Headache is the common symptoms experienced by more than 50% people worldwide.
Headache is one of the problems that give headache to the treating physician because of the multiple types and multiple causes.
What is a Cause of headache?
Headache is the ache(pain) arising from structures and tissues around the brain and skull like eyes, sinuses, ear, muscles, blood vessels, nerves and spinal cord. Brain itself cannot feel pain.
Headache can also be a symptom of some other serious condition or disease.
Headache is three times more common in women than men.
What are the types of headache?
There are many varieties of headache and lots of subtypes.
The most common types of headache are Tension Headache, Migraine and Cluster Headache.
Tension headache is usually bilateral (both sided) and it is not pulsatile. It is a dull ache felt all over the head. Tenderness may be felt around the scalp muscle and neck. There is no associated nausea or vomiting. Scalp muscle tenderness may be present. Tension headache is often triggered by mental stress.
Stress relief, antidepressants, analgesics and gentle massage may help to reduce the pain.
Migraine is a miserable form of headache normally affects one side of the head. Migraine is usually associated with nausea and vomiting. An aura (seeing flash of light, blind spots, stars or zig zac lines ) may precede the ache. Migraine can occur without aura also. Migraine headache may be throbbing and may be worsened by routine activities
Migraine is due to disturbance in the brains vascular tree. Dilatation of blood vessels produces pain due to stretching of the arterial wall. Migraine may be triggered by flashing light, anxiety, stress, exercise, menstruation, oral contraceptives, chocolate, artificial sweetener, mono sodium glutamate (agino moto) and alcoholic drinks.
Cluster headache is the most disabling type of headache. It is characterized by sudden onset of excruciating pain around or behind one eye. The eye may become bloodshot, watery and lacrimating and may have eye lid swelling. Cluster headache usually starts at night and lasts for few minutes to hours. One headache will resolve and another will follow. It comes in cluster for few weeks followed by headache free period of months. Cluster headache is more common in men than women.
Other Types of headache
Sudden single attacks
Patients can have acute headache for short period in conditions like head injury, fevers, sinusitis, meningitis, encephalitis, bleeding in side skull like subarachnoid haemorrhage, sudden increase or decrease in blood pressure and over straining can also produce headache.
Increased intra cranial pressure, tumors of brain, decreased CSF pressure after lumbar puncture or spinal anesthesia can also produce headache.
Infections of eye, glaucoma, refraction errors and over strain to eyes may give headache.
Dental conditions, diseases of the nose and sinuses, diseases of ear and cervical spondylosis can also produce headache.
Headache due to condition in nerves
Conditions in cranial nerves can produce headache like Trigeminal neuralgia, Glossopharyngeal neuralgia and Temporomandibular neuralgia can produce headache.
Conditions like anxiety, depression, schizophrenia and hysteria can produce headache. They are of pressing type, continuous and severe. The headache are not relieved by analgesics.
Throbbing headache increases on movement of the head.
Usually affects elderly people at night and wake them up during sleep.
Drinking too much alcohol at night may produce throbbing headache next morning. Drinking lots of juices and eating sugary food to reduce the headache.
Taking too many medicines regularly for headache, becoming dependent on the medicines and suddenly stopping the drugs may produce rebound headache.
Drinking lots of coffee daily and withdrawing coffee suddenly cal alter the brain chemistry and trigger headache.
Ice cream Headache
Drinking Ice cold drinks or eating very cold ice cream can stimulate the nerve ends in soft palate and produce headache.
Pregnancy, menstruation or taking birth control pills can alter the hormone levels and produce headache.
Investigations for Headaches
Detailed history of the Headache, the type of headache and associated symptoms will give a clear idea about the investigations to be done.
X-rays of skull, Para nasal sinuses and cervical spine will give evidence regarding the headache.
CT scan or MRI scan of brain may be necessary to rule out intracranial causes.
Ophthalmic, ENT (Ear, nose and throat), and dental examinations will rule out referred pain from these organs.
Psychiatric assessment is also necessary.
How do you get rid of a headache?
It is better to consult your physician than taking over the counter medications.
Rest, gentile massage, breathing exercises, warm or cold compress and stress busters will relive headache.
Medications like Aspirin, Ibuprofen, Aceclofenac and Paracetamol can be given to reduce headache.
In migraine Triptans and Ergot alkaloids will relieve pain. Flunarizine, propranolol or amitriptyline can prevent migraine attack.
Treat the cause in referred headache.
Removing triggers, avoiding stress, positive attitude, yoga and meditation will prevent headache.