Headaches are a common ailment experienced by people worldwide, with the majority of individuals encountering them at least once in their lifetime. While some causes are harmless, others can be more concerning. Headaches are generally categorized into primary and secondary types. Primary headaches have no specific identifiable cause, whereas secondary headaches are linked to various factors such as high blood pressure, sinusitis, infections, blood clots in the brain, traumatic incidents, or tumors. Recognizing, evaluating, and effectively managing headaches is crucial for enhancing the quality of life for patients.
Tension-type headache: This type of headache is characterized by mild to moderate pain, often described as a sensation of a tight band around the head. It is the most common form of headache.
Migraine: Migraine headaches are highly debilitating. They typically affect one side of the head and can last from 4 to 72 hours if left untreated. Nausea, vomiting, and sensitivity to light and sound often accompany migraines. Triggers for migraines can include factors like missed meals, lack of sleep, alcohol consumption, certain smells, or exposure to sunlight.
Cluster headache: Cluster headaches, known as "suicidal headaches" due to their excruciating pain, occur behind the eyes and feel like being stabbed in the eye. Redness of the eye, watering of the eye and nose are associated symptoms.
Post-traumatic headache: This type of headache occurs following head or neck injuries. It typically emerges around seven days after the injury and may persist for months. The pain can be located in the front or side of the head, or in the neck.
Medication overuse headache: Individuals who frequently rely on painkillers to alleviate recurrent headaches may develop medication overuse headaches.
Sinus headache: Sinus headaches manifest as continuous pain felt inside the cheeks and forehead. Associated symptoms may include fever, nasal congestion, and post-nasal drip.
It is important to be aware of "red flag" symptoms associated with headaches, which require immediate attention and treatment. These symptoms include the sudden onset of a headache, very high blood pressure, age over 50, headaches during pregnancy, headaches that awaken from sleep, double vision, weakness in the hands and legs, or seizures.
Headache treatment involves either abortive or preventive measures. Abortive therapy consists of taking medication once symptoms arise, while preventive therapy entails taking a course of medication to prevent headaches from occurring. The choice of medication should be tailored to each patient, considering factors such as age, gender, associated symptoms, and any existing medical conditions.
When experiencing a headache, it is recommended to find a dark and quiet place, drink a tall glass of water, lie down, place a cold cloth on the forehead, take over-the-counter or prescribed headache medication as advised by a doctor, and attempt to rest or take a nap.
In certain situations, it is necessary to seek immediate medical attention. These include experiencing a sudden and severe headache, a headache triggered by exercise, a headache lasting more than three days, the presence of fever, a stiff neck, seizures, neurological deficits, a headache following trauma, or headaches during pregnancy. These cases may require neuroimaging investigations to rule out serious underlying causes.
Dr Soniya Tambe, MD, DM(Neurology), Migraine Certification (Mayo clinic), Neurologist and Epileptologist, Kauvery Hospital, Electronic City, Bangalore.
