HEADACHE: Causes, Symptoms, Diagnosis, Treatment, Prevention

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What is a Headache?

A diffuse pain in head which is not limited to a certain distribution area of any nerve is known as headache. The term can indicate pain in any part of the head, either back, front, one sided, both sided or one half.

Headache Types and Causes

Primary Headaches – Certain stimuli trigger these types of headaches and not some other medical condition. It involves various types of headaches like tension headache, migraine and cluster headache.

Secondary Headaches – These types of headaches are usually experienced due to some other medical condition. Most of the times, the cause of secondary headaches is obvious.

Causes of Headache

Based on the conditions, headaches can be classified into 3 types and each kind has its own causes.

Sudden or Acute Headache:

An acute or sudden headache can be experienced due to various reasons and medical conditions like dehydration, food-related causes, severe and unabated cough, use or withdrawal of certain drugs, sinusitis, concussion, intracranial disorders and premenstrual syndrome. Even the excessive use of hair accessories, hats and helmets can cause acute headaches. Lack of oxygen or eating contaminated food are also rare causes of headache.

Recurrent or Chronic Headache:

A recurring or chronic headache has other reasons than acute headaches. These include constipation, anemia, smoking, use of illegal drugs, excessive consumption of alcohol, upper body disorders, deficiency of vitamins, chronic infections like AIDS, malnutrition and adrenal disorders. Other medical conditions igniting chronic headaches are high blood pressure, liver or kidney failure, cancer, hypothyroidism, fatigue, brain tumor and psychiatric disorders.

Cranial Neuralgia:

Also known as nerve pain, it is caused by trigeminal neuralgia, occipital neuralgia, gloss pharyngeal neuralgia and burning mouth syndrome.

Headache Symptoms

The cause of a certain type of headache can be determined by the various characteristics noticed:

* Headache experienced on both sides of head can indicate some internal head disorder, systematic illness or tension headache while a one-sided headache indicates migraine or cluster headache.
* Signs of aura in a patient point towards migraine or seizures.
* Sudden severe headache is caused due to intracranial bleeding and high blood pressure.
* A sharp, shooting headache is the result of trigeminal neuralgia, multiple sclerosis or else some disorder of TMJ joint.
* Migraine, temporal arteritis and anemia lead to a throbbing or pulsating headache.
* Headache experienced when waking up may be due to spinal disorders, restless sleep or sleep apnea.
* Neck stiffness and head ache simultaneously are seen in torticollis, meningitis, spinal disorders and encephalitis.
* Conditions like sinusitis, multiple sclerosis or trigeminal neuralgia cause facial pains.

Headache Diagnosis

The main causes for a headache can be diagnosed by various tests based on the conditions and severity. The symptoms too direct the path of investigation and treatment for a headache.

A physical examination is the basic test carried out and is sufficient in cases when the symptoms are clear enough. In cases when physical examination isn’t clear enough, various tests and investigations are carried out. These include X-ray, CT of head, MRI and Brain Angiography. A spinal tap too is recommended for doubts about conditions like infectious meningitis, neurosyphilis, carcinomatous meningitis or neuroborreliosis. For diagnosing any internal fluid disorders, blood and urine tests are done.

Headache Treatment

Any treatment for headache varies according to its severity and type. Initially some general steps are taken like drinking fluids, taking rest, warm and cold compress, massage and soft cervical collar. The drugs for treating headache include acetaminophen, Excedrin migraine, aspirin, ibuprofen, antihistamines, chlorpromazine, antihistamines, lidocaine, midrin and triptans. Oxygen canisters are used for treating cluster headache.

Headache Prevention

To prevent headache simple measures are necessary like the following:

* Drink enough water
* Regular meals
* Good sleep
* Regular exercise
* Avoiding stress
* Using painkillers moderately.

The medications used for prevention of migraine include methysergide, riboflavin, propranolol, pizotifen and dexamethasone.

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