Headaches are one of the commonest health complaints and could be an important pointer to various diseases. They are a wide range of pains in the head region. The nature of the pain varies and could be dull, throbbing, pulsating or sharp with the varying intensity. It could be localized to a part of the head or widespread.
There are over 150 types of headaches but are classified into two according to the International Headache Society (HIS)
They are the most common type of headaches are primary headaches. They are not caused by any underlying condition but due to problems with structures within the head that are sensitive to pain (blood vessels, nerves or muscles) Examples of primary headaches are :
- Cluster Headaches: They last 15 minutes to 3 hours and might occur up to three times a day although the inter-cluster headaches might also be up to years. The headache comes with an intense burning sensation around the eyes and associated with nasal congestion and tearing of eyes.
- Migraines: Present with pulsating, pounding or throbbing pain that may last between hours and three days and usual located in one side of the head. They may be associated with nausea, blurring of vision and sensitivity to light, smell or noise.
- Tension Headaches: the commonest of the types of headaches. The present with “band-like” pain involving both sides of the head. The pain is dull and starts slowly with gradually increasing intensity.
These are due to an underlying problem. The causes include:
- Infection like meningitis, acute sinusitis, middle ear infection
- Bleeding in the head
- Brain tumour
- Hangover (Alcohol)
- Panic attack
- Post-ictal (after convulsion)
- Over-use of pain drug
- Tooth problems
- Poisoning – Carbon monoxide
- Drugs used to treat other conditions
Types of secondary headaches include:
- Ice cream headaches: brief, stabbing headaches also called a “brain freeze” and felt after inhaling something cold or biting into ice cream.
- Spinal Headaches:caused by reduction in volume or pressure of the cerebrospinal fluid and most often occurs after a spinal tap or spinal anaesthesia.
- Thunderclap Headaches: rare but severe and sudden headaches that feel like “the worst headache one has ever had”. They could be as symptom of a life-threatening condition like an intra-cranial bleed, pituitary apoplexy.
Headaches might be a common condition but it is far from being always benign. They could represent danger signs and if not well recognized in time could lead to late intervention. The following are some symptoms that should be looked out for
- Slurring speech or weakness of hands or/and legs
- Stiff neck or high-grade fever (39oC to 40oC)
- Blurring of eye sight
Rest and pain medications are most commonly used. Tricyclic antidepressants, beta blockers, serotonin
Based on the characteristics of the headache, other associated symptoms and results from investigations carried out, the doctor can decide how best to treat a headache. The type and cause of headache determines the treatment best suited for the headache.